Richard D Winter, D.D.S

Complaint involves billing and collection issuePatient has been a long term patient, and was experiencing some pain since 11/14/Patient was seen in our office times after that(She failed to show up to scheduled appointments times.) Pain medications were given and/or treatment provided at all appointmentsShe was referred to a specialist for a root canal and did see that Drfor treatmentOur office followed up with the specialistThe patient's account with our office reflects that insurance claims were submitted in a very timely manner for all treatment she received and co-payments were billed monthly.(We bill every days.) However, the patient did not provide our office with a secondary insurance that she had for a period of approximately months (even though we requested the information many times)Patient states that she has tried to call us for months with no answerOur office staff returned her calls on a regular basis, we often left detailed messages, answering her questions and leaving information about her account, her insurance and the status of claimsIt is simply not true that we have not returned her calls, and our phone records would easily show that this is trueIt is the patient's responsibility to provide our office with accurate and complete insurance informationAs a courtesy to the patient we make every effort to verify the information provided, and this was done for this patientOur records indicate clearly that patient signed a statement with the following: "Even though I may have dental insurance coverage, I understand payment for services rendered is my responsibility." Review of the patient ledger indicates she was given discounts for treatment totaling $since becoming a patient with usWe have tried many times to resolve this issue with this patient and have not been able to do soThis patient is responsible for their account, and we feel we have been more than fair and forthright in dealing with herOur office is open Tuesday, Thursday, Friday, Saturday from 8-We answer our phones Monday-SaturdayThis is a case of the patient wanting us to forgive her bill, when she failed to provide our office with insurance information we requested, numerous times, and for unknown reasons stating that we did not return her calls, when clearly numerous staff members have called her backThis person has also written a bad yelp review in an effort to force us to treat her without being paid for work already done

I would just like to say one thing Rather than try to blame the customer and keep accusing them that they never have given the correct secondary insurance...I just found out some big news Since this whole ordeal, I reached out to my secondary payer to see what has been billed I have been enrolled with them since 2013- I have no reason to not give you the info if I'm paying monthly for it They have NEVER been billed till I looked back at my primary payer statements and I was charged in for all the remainder charges that my primary didn't cover I remember specifically asking why I was paying out of pocket since I had two insurances and you replied that I went over both coveragesI'm suppose to trust you guys because you bill ALL the time That's part of your jobCome to find out that you never billed because no one tried to find which secondary payer it should go to What kind of customer service is this? When I gave you my secondary- no one ever questioned me about why no one was accepting the claims- instead I was lied to and you guys said I went over both coverages This REALLY upsets me You can upload and document anything you want about me saying I never had a secondary, but who knows what you edited I don't appreciate being lied to and what can I do about all the payments I made in when nothing was billed to my secondary? That is about $that I had to pay out of pocket when my insurance could cover it I have lost all confidence in you guys I have been lied to so many times I have been taken advantage of and since you guys run a business, how about trying to work with the client rather than shifting blame The balance that I currently owe should be written off since I paid out of pocket in You keep saying all these discounts, I only know of $100, where did the rest come from that I have no idea about? Like I said, you can say all you want but all the actions that I have encountered through this whole ordeal has been horrible and the worst customer service ever No one keeps their word and all the lies If you didn't know what my secondary insurance was in November 2015, why would you tell me I had enough credit to do the deep root cleaning than turn around and say something else? As a client, I put trust in my doctor offices so I believe what you tell me You guys do not know how to bill that's why I was left with all those payments in and now It's really a shame I have never encountered a practice that shifts blame on their long term clients I'm truly appalled to have been going to this dentist office after all these years What info was sent to me? I have not received anything but this ongoing statement

Complaint involves billing and collection issue. Patient has been a long term patient, and was experiencing some pain since 11/14/14. Patient was seen in our office 9 times after that. (She failed to show up to scheduled appointments 6 times.) Pain medications were given and/or treatment provided at...

all appointments. She was referred to a specialist for a root canal and did see that Dr. for treatment. Our office followed up with the specialist. The patient's account with our office reflects that insurance claims were submitted in a very timely manner for all treatment she received and co-payments were billed monthly.(We bill every 30 days.) However, the patient did not provide our office with a secondary insurance that she had for a period of approximately 10 months (even though we requested the information many times). Patient states that she has tried to call us for 3 months with no answer. Our office staff returned her calls on a regular basis, we often left detailed messages, answering her questions and leaving information about her account, her insurance and the status of claims. It is simply not true that we have not returned her calls, and our phone records would easily show that this is true. It is the patient's responsibility to provide our office with accurate and complete insurance information. As a courtesy to the patient we make every effort to verify the information provided, and this was done for this patient. Our records indicate clearly that patient signed a statement with the following: "Even though I may have dental insurance coverage, I understand payment for services rendered is my responsibility." Review of the patient ledger indicates she was given discounts for treatment totaling $695.00 since becoming a patient with us. We have tried many times to resolve this issue with this patient and have not been able to do so. This patient is responsible for their account, and we feel we have been more than fair and forthright in dealing with her. Our office is open Tuesday, Thursday, Friday, Saturday from 8-5. We answer our phones Monday-Saturday. This is a case of the patient wanting us to forgive her bill, when she failed to provide our office with insurance information we requested, numerous times, and for unknown reasons stating that we did not return her calls, when clearly numerous staff members have called her back. This person has also written a bad yelp review in an effort to force us to treat her without being paid for work already done.

After receiving the recent rebuttal, I will once again state that I have forwarded you copies of all the information regarding this complaint.  I have also forwarded copies to this person making the complaint.As you most likely have reviewed at this point, we included copies of all the insurance information provide to our office by this patient.  We can only have this information if the patient provided it, and since there are copies of the insurance cards, you can see this is exactly what was provided to our office.  Our insurance specialist made every effort to collect the balance due from the insurance companies provided on many occasions, and again this is included in the packet information we provided.  Our office made several attempts to clarify what the proper insurance plan was, and this was done by telephone messages.  Eventually, after the payment was not made by the insurance companies we had in our file (provided by the patient, and in your packet) the patient came into the practice and gave us the correct information. That was billed immediately then to the correct company.  Either way, however, the bottom line is all patients are responsible for their own account regardless of any insurance.  In  this form of responsibility it clearly states ( in the patient registration information) and was clearly signed by this patient on two separate occasions that the patient is responsible for the account regardless of insurance.  Again, copies of these forms with her signature were sent along in your packet. Even if this person had zero insurance, or the insurance they had paid zero, the cost of treatment is the patient's responsibility.  I am not sure why this fact is not being acknowledged by this patient.  All patient estimates given state clearly, "This is only an estimate. I understand that fees may vary at the time of service due to the extent of treatment.  Fees are estimates only and are not a guarantee of payment by your insurance company.  I understand that payment of this account is my responsibility, regardless of the amount my insurance company reimburses before or after payment is made." We have given this patient the discounts equaling $559.15 and the documentation to prove this was sent to you and to the patient. The patient states that "this is not about the money or discounts, and that our office apologized to her already."  We routinely try to resolve any issue that arises with a patient, and we would always apologize if we see made an error.  The apology was given when the patient was upset because we billed the insurance we had on file and it delayed them paying. (Again, this is the insurance card we sent you, and the patient gave us.)  If the correct insurance had paid us because we billed that insurance first, then it would not have paid the other office she went to and she would be upset with the other office for billing her for the work.  There is a maximum on the insurance per year and she used it all before they paid us, therefore she is responsible for the fees incurred for services performed and agreed to by her.  Either way, the insurance would only pay up to the maximum, and that would be our office or another office.  She signed an agreement stating she would be responsible for the account, and therefore we hold her responsible for the account.  It is her insurance company, and she was aware of the fees we charged for the service she accepted.Honestly, this needs to be resolved based on the facts.  The facts are clear in the patient chart, and it has all be sent to you and to her to confirm.  Again, I have agreed to work with the patient on a payment plan if she needs to do that.Please let me know when we can resolve this matter.[redacted]Patient Coordinator