Randy A. Stauffer, D.D.S.

Initial Business Response /* (1000, 5, 2016/07/26) */
Ms. [redacted]
[redacted]
Elkhart, IN XXXXX
Dear Ms. [redacted]:
This letter is in response to the complaint filed to the Revdex.com regarding not only your experience here but your disputed account. In January of 2015 we welcomed...

both you and [redacted] back to our practice following a nearly 3 year absence. At that point your account balance was zero. Over the next several months up until August of 2015, both you and [redacted] had several visits for restorative and preventative care. Fees from our office totaled [redacted] Both personal and insurance payments have been received over that time. Service charges have also been incurred as the 60 day grace period for payment in full has been expired. Current balance stands at [redacted] Prior to any visit, before completing any procedure, we give patients an estimate of what the treatment will be and an estimate of what their insurance will cover based on the information provided to us. When estimates are made, we can estimate our fees very accurately, with the only changes that occur are generally related to a change in clinical manifestation of the problem we are addressing, meaning the problem is wither better or worse and subsequent cost of treatment will be more or less based on clinical need. If a filling becomes bigger, discussion of that change is generally discussed post-op. If the change in treatment is more significant, perhaps an area now needs a root canal and was treatment planned for a filling, that need to amend the proposed treatment would be discussed immediately, as that would make a significant change to proposed treatment and more importantly estimated cost. No treatment is ever completed without patient consent. Patients have autonomy. Patients may elect to have treatment completed or not. Once a patient schedules an appointment for treatment, it becomes our job to take care of that dental need per the patient's request to the best of our ability. Enclosed is our financial consent document that stated that patients are responsible for all charges that are accrued in our office. The area highlighted. Your signature is at the bottom of the page. No complaint on treatment has ever been received. The only complaint revolves around what YOUR insurance company reimbursed for YOUR treatment. Estimates on what your insurance might cover for any procedure prior to completing that procedure is just that, and estimate. Ultimately it is your insurance plan. We submit dental claims for you. We will answer questions an insurance company may have regarding care provided. Your insurance paid less on your claim that what we may have estimated based on the information you have provided our office regarding your coverage. That is an issue between you and your insurance company. We have provided services as was discussed prior to completing those services, and now expect to be paid for those services. While we do make payment arrangements for most balances, we do require that those balances be serviced regularly and on time. Neglect to fulfill your financial obligations results in actions deemed necessary by our accounting staff. We would hope that your fulfill financial obligation to us and bring your account up to date. I have instructed the accounts staff to accept a [redacted] payment to bring your account current and then we may return to the [redacted] monthly payments to continue until your account is paid in full ( a copy of your ledger is included). We will look forward to receiving the [redacted] payment by 8/10. Failure to receive that payment or subsequently delinquency will result in the need to follow our accounting staff's policy and refer your account on to our collection service. Please help us avoid this step and bring your account current and be mindful to keep it current. Other that our monthly statement, no additional reminders or request for payment will be sent. As means to avoid any confusion about future services, we will no longer accept assignment of dental benefits for you or your daughter. We will give an estimate for the services rendered, complete those services, and upon completion of those services collect payment for those services. We will be happy to file your insurance claims for you and assign benefits back to you. This way there can be no confusion on what insurance benefits might be paid, the only estimate you will receive is for services expected to be performed by myself or my staff. This letter has been forwarded to the Revdex.com in response to your complaint.
Cordially,
[redacted], DDS
Initial Consumer Rebuttal /* (3000, 7, 2016/07/28) */
(The consumer indicated he/she DID NOT accept the response from the business.)
The provider is correct that when my daughter and I came to the office in 2015, the account balance was [redacted] I was seen by the provider years ago (appr. 2007) and paid the amount in full.
I accept the partial response form the provider. I agree that both, my daughter and I, were seen and served by the provider. I have no concerns regarding my service and the billing for my service.
My concern is regarding the communication (or miscommunication) between the provider's office and my daughter's insurance. The estimate I was given prior to the service and the bill I received after the service were very much different. That was the reason I had to contact my insurance and was inform that the material that was used by the dentist was not covered by the insurance. That was the provider's office responsibility to find out this information and inform me, so I could make an inform decision and seek a different provider.
Unfortunately, I do not have a copy of the initial estimate that I was provided and sign (it was appr. [redacted] I would like the office to request a copy of that estimate and the copy of their communication with the insurance and the reason why the insurance denied to cover the service.
Sincerely,
[redacted].