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Putnam Family Dental

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Putnam Family Dental Reviews (1)

I recently went for a routine cleaning ( that is fully covered by my insurance ). While I was there they asked if they could do a full mouth series (X-rays). Since I was not experiencing any issues at the time I told them that they needed to be 100% sure my insurance would cover this because I was not going to pay for a service that I didn't feel I needed. The lady left the room, came back and stated that "yes, my insurance would fully cover this", so I agreed. Later I am sent a bill for $ 120.00. I call to ask what I am being billed for and the lady who handles payments stated that my insurance was not going to fully cover the services I recently had. I am then told to contact my insurance to find out why I am not covered. My insurance went through my past bills and notified me that they cannot cover the full mouth series because they ([redacted]) did not wait long enough since the last full mouth series was taken. My insurance stated that if they would have waited until November 11th of this year I would have been fully eligible for procedure. This tells me that [redacted] guessed as to whether or not I was going to be covered for this procedure and simply told me "yes" so that I would agree ti have this done and be stuck paying them money that I did not agree to pay. I have had many other issues with this dentist and unfortunately continued to go to them simply out of connivence. Obviously I should have taken more time to carefully select a dentist that I felt actually cared about the patients they had rather than the dollar in their pocket.Desired SettlementI would like to see this business step up to the plate and take responsibility for their mistake. I would like them to drop the bill for 120.00. Business Response Contact Name and Title: [redacted]Contact Phone: XXX-XXX-XXXXContact Email: [redacted]@yahoo.comWe will respond to this complaint in the order of notes put in the complaint. Inother words, we iwll break it down and answer each note to make it easiest to comprehend.1."I recently went for a routine cleaning ( that is fully covered by my insurance)". This statement is true for most patients with dental insurance, especially that our office is an in-netwowrk provider with Ms [redacted]'s dental insurance. However this statment is incomplete and inaccurate. The appointment would, normally, constitute a cleaning, an exam and radiographs (xrays). The eligibility of any patient for all these procedures is determined by the dental insurance (contracted third party) and the patient is responsible to check eligiblity for these services. Having stated that, our office ALWAYS helps our patients by explaining any terms or clauses related to the procedures before they are administered and calling the dental insurance to find such things out for the patient as and whenever needed. It is, simply, our office policy. 2."Since I was not experiencing any issues at the time." More than one radiograph was taken, including a panoramic radiograph. This was needed because the patients signs and symptoms lead to suspicion of involvement of wisdom molars. And the radiograph did show impacted wisdom molars that were harmful to the patient's health and was a critical step towards diagnosis and treatment planning. We discussed the need and rationale for wisdom molar extractions.3. "I told them that they needed to be 100% sure my insurance would cover this because I was not going to pay for a service that I didn't feel I needed. The lady left the room, came back and stated that "yes, my insurance would fully cover this", so I agreed." We did check with the dental insurance, per Ms [redacted]'s request, and the representative that responded to our office's phone call did state they Ms [redacted] was eligible for coverage for the designated procedures. There is no better way for our office to find out. As stated in the contract between Ms [redacted], and also stated in the contract between our office and the same dental insurance, patient eligibility and coverage are the sole responsibility of the patient to find out. However, we do try to help our patients, including making phone calls to the dental insurance.4. "My insurance went through my past bills and notified me that they cannot cover the full mouth series because they ([redacted]) did not wait long enough since the last full mouth series was taken." This obviously looks like the dental insurance may have made wrong statements to our office at the time, but that does not cancel the patient's responsibility and does not hide our office's position to always help and take the extra step to call the dental insurance, if the patient asks for it. Also, as part of our policy towards the maintenance of oral health of all of our patients, we don't expose them to radiographs randomly. Radiographs are taken based on need. In Ms [redacted] case, radiographs were taken with reference to her past and future treatment and the need to diagnose what was suspected to be a problem/disease. And the radiograph taken, was extremely helpful for that matter. In other words, Ms [redacted] was informed of the need for treatment that we would not have determined without taking the radiograph (xray). We would not "wait" to take radiographs unless two things happen together: 1. they are needed and 2. the patient (Ms [redacted]) agrees to have them done. And both conditions happened. If, alternatively, both conditions were valid and we waited, this would have been considered unethical and malpractice.5. "My insurance stated that if they would have waited until November 11th of this year I would have been fully eligible for procedure. " Is this information had been given to our office, we would have gladly informed Ms [redacted] and left her to decide. We do not hide any information from our patients. This, however, does not displace the fact that it is the patient's responsibility to find out the exact details of her dental insurance coverage. We only try to help.6. "This tells me that [redacted] guessed as to whether or not I was going to be covered for this procedure and simply told me "yes" so that I would agree ti have this done and be stuck paying them money that I did not agree to pay." This is a false statement/conclusion, we never conduct our activities in this manner. 7. It is also worth noting that all eligibility, coverage and fees are not billed to the patient until the dental insurance replies to our billing with an Explanation of Benefits (EOB) statement. A copy is also sent to the patient. This statement informs our office, in addition to the patient, of what is payable, if there is any financial responsibility by the patient.During that same visit, two other procedures performed, were not paid for by the dental insurance, whom also stated that they need to be written off (i.e. not to be charged to the patient). And so we did as as stated in the EOB, because we have to follow the policies of the contract with the dental insurance.The dental insurance determined that panoramic radiograph fee will not be written off and is Ms [redacted]'s responsibility to pay, after discounting it to the allowed fee by the dental insurance. And so, we billed Ms [redacted] according to the contract between us, the dental insurance and Ms [redacted].8. We did offer Ms [redacted] a payment plan but she refused to discuss the option. WE are still open to giving her a discount. We have no interest in having any conflict with any of our patients.[redacted]

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Description: Dentists

Address: 108 N. Jefferson, Pandora, Ohio, United States, 45877

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