Richard P. Denise D.D.S.

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the responseIf no reason is received your complaint will be closed Administratively Resolved]
Complaint: ***
I am rejecting this response because: nothing was resolved in the issue and Richard response was not all factualAnd I tried to make payments and talk to him and he refusedAnd i'm not trying to get over on him but I did ask for consideration in the matter and I hadnt been to his office since 2010, how is someone suppose to know what insurance was in network and he said I had a different insurance then why wouldn't he let me know that my new insurance was not in network
Regards,
*** ***

April 16, 2014
Dear Revdex.com,[redacted] first came to my office for treatment on her son [redacted] in 2009, at which time she signed an office policy which stated all billing procedures (a copy is enclosed with this letter). He had 9 fillings in 2009. [redacted]'s insurance...

has always been [redacted]. In 2009 claims were processed through [redacted]. At the very least [redacted] knew that her claims were not 100% covered in 2009, in 2010 [redacted] had one filling placed. In 2011 he had three more fillings placed. [redacted] is not very responsible in paying her dental bills, She has had ten rebllling fees for overdue bills with my office between 2009-2010. She would eventually get caught up on her bill when she wanted to be seen again.On April 5, 2013 (Not February2013) [redacted] brought [redacted] in for an extraction and an emergency exam. The total bill for that date of service was $223,00. [redacted] admitted that she would be responsible for 20% of this bill in her letter to the Revdex.com, 20% would be $44.60 not $20.00. [redacted] brought [redacted] in for dental cleaning, exam, and another extraction on April IS, 2013, the total bill for that day was $364.00. She came back again and brought Tristan on October 9, 2013 for dental cleaning, exam, and x-ray, in which the total bill was $238.00- [redacted] insisted that my office process claims through [redacted]. The claims were rejected several times. My staff discovered that [redacted] was no longer processing claims. The claims needed to be sent directly to [redacted]. The delay in payments was due to [redacted]'s actions. The claims were eventually processed and paid. The balance prior to the payments from insurance was $2716.00. The balance after all payments were received from insurance was $578.00. This is approximately 20% of the total. I offered a 10% discount which was rejected by [redacted], so I reversed it. Since December [redacted] has made two small payments of $9.00 and $15.00, bringing her current balance to $554.00. [redacted] is trying to pull a bait and switch on me. She runs up a bill and does not want to pay her portion. Most dental insurance companies pay 100% of a cleaning. My office is out of network with her insurance and always has been, and therefore cleanings are not 100% covered. [redacted] is an adult is should be knowledgeable of her insurance coverage, [redacted] has known that we are out of network for about 5 five years. Any statements to the contrary are a falsehood. The letter from [redacted] is riddled with inaccuracy and she has a memory of convenience. I do not deal with billing, which is why I have an office staff. Right now [redacted]s account is poised to be sent to an attorney for collections, as it is four months overdue, unless you can assist in resolving this matter. Unfortunately 35 years of experience has shown me that the loudest complainers are the ones who don't want to honor their responsibilities and obligations.Regards,

Review: I went to Dr. Denise to have my family of 5 teeth cleaned in Oct 2013. I have not use this doctor for a long time since 2009, when I had fill-ins done for my son’s teeth which was a standard 20 % for the services performed which was fine. So in Feb 2013 the same thing needed to be corrected with my son’s teeth which at the time of service I asked how much my bill was and they said 20 dollars which is about 20 % of service bill, in which I paid at that time. I received no other bills from the doctor’s office until I decided to go in Oct of 2013 to get my family teeth cleaned. At the time of the visit is when I found out my insured company had never been charged for services performed in Feb 2013. So that’s fine It was solely on the doctor’s office. But not one time in 2009 and 2013 did at anytime did anyone tell me that I was out of network in which you pay for your cleaning. I never had my teeth cleaned before there and never really used the company other than the corrections to my sons teeth. But that’s not even my biggest problem, after complaining and having Jessica at the front desk call me a liar, stating she told me that I was out of network, which made no since( why would someone want to pay 100 dollars per person to get their teeth clean when they can get it done for free). So Dr. Denise look at my bill and took 10% off but after 2 months of me trying to contact him about the bill he finally decided to take away the 10% and said I had to pay for the whole bill. This is poor customer service and I can’t believe they would fail to tell a customer they are out of network and don’t even try to correct the issue. This is almost like bait and switch.Desired Settlement: Meet somewhere in the middle for this issue. I am not asking for everything to be taken off my bill but something corrected off my bill( more than 10%).

Business

Response:

April 16, 2014Dear Revdex.com,[redacted] first came to my office for treatment on her son [redacted] in 2009, at which time she signed an office policy which stated all billing procedures (a copy is enclosed with this letter). He had 9 fillings in 2009. [redacted]'s insurance has always been [redacted]. In 2009 claims were processed through [redacted]. At the very least [redacted] knew that her claims were not 100% covered in 2009, in 2010 [redacted] had one filling placed. In 2011 he had three more fillings placed. [redacted] is not very responsible in paying her dental bills, She has had ten rebllling fees for overdue bills with my office between 2009-2010. She would eventually get caught up on her bill when she wanted to be seen again.On April 5, 2013 (Not February2013) [redacted] brought [redacted] in for an extraction and an emergency exam. The total bill for that date of service was $223,00. [redacted] admitted that she would be responsible for 20% of this bill in her letter to the Revdex.com, 20% would be $44.60 not $20.00. [redacted] brought [redacted] in for dental cleaning, exam, and another extraction on April IS, 2013, the total bill for that day was $364.00. She came back again and brought Tristan on October 9, 2013 for dental cleaning, exam, and x-ray, in which the total bill was $238.00- [redacted] insisted that my office process claims through [redacted]. The claims were rejected several times. My staff discovered that [redacted] was no longer processing claims. The claims needed to be sent directly to [redacted]. The delay in payments was due to [redacted]'s actions. The claims were eventually processed and paid. The balance prior to the payments from insurance was $2716.00. The balance after all payments were received from insurance was $578.00. This is approximately 20% of the total. I offered a 10% discount which was rejected by [redacted], so I reversed it. Since December [redacted] has made two small payments of $9.00 and $15.00, bringing her current balance to $554.00. [redacted] is trying to pull a bait and switch on me. She runs up a bill and does not want to pay her portion. Most dental insurance companies pay 100% of a cleaning. My office is out of network with her insurance and always has been, and therefore cleanings are not 100% covered. [redacted] is an adult is should be knowledgeable of her insurance coverage, [redacted] has known that we are out of network for about 5 five years. Any statements to the contrary are a falsehood. The letter from [redacted] is riddled with inaccuracy and she has a memory of convenience. I do not deal with billing, which is why I have an office staff. Right now [redacted]s account is poised to be sent to an attorney for collections, as it is four months overdue, unless you can assist in resolving this matter. Unfortunately 35 years of experience has shown me that the loudest complainers are the ones who don't want to honor their responsibilities and obligations.Regards,

Consumer

Response:

[To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed Administratively Resolved]

Review: [redacted]

I am rejecting this response because: nothing was resolved in the issue and Richard response was not all factual. And I tried to make payments and talk to him and he refused. And i'm not trying to get over on him but I did ask for consideration in the matter and I hadnt been to his office since 2010, how is someone suppose to know what insurance was in network and he said I had a different insurance then why wouldn't he let me know that my new insurance was not in network

Regards,