Roanoke Valley Dental

Review: My dentist recently retired and sold his business to Alice Pham Bower. A nice letter was sent out to all of his current patients, but at no time was anything mentioned about billing changes and that you may want to call your insurance carrier and make sure that she was in network. Therefore, I was under the impression that the business was bought as a whole, billing identifiers and all. I went for a 6 month check up/cleaning and received an EOB from [redacted] stating that Alice Bower is out of network and that my normally covered visit will cost me $75. I called and spoke to the receptionist/billing person. She spoke with Alice and called me back stating that it was my responsibility to ask if the billing had changed and that I should know my policy. I was also told that the $75 would be billed to me. This is not about the money. It's the principal of the matter. I feel this is unethical and that they had a responsibility to inform us of the change.Desired Settlement: I would like to not be billed for the $75 and have them inform the rest of the patients that the billing has changed and they should call their insurance carrier before coming in for any procedure.

Business

Response:

We regret that tire patient incorrectly assumed Dr. Bower was an in-network participant of her insurance plan.

However, it is the responsibility of the patient, not the provider, to understand the patient's own insurance plan. If

seeing an in-network provider is important to a patient, she should contact her insurance company to verify network

participation, or request that the provider's office verify her plan, especially when the patient will see a new provider

for the first time. In this case, the patient did neither.

The patient came to the office for services, and a claim of $134 was submitted to the patient's insurance company for

reimbursement. All fees were the same as the previous provider prior to Dr. Bower's acquisition of the practice. Of the

total fees submitted, the patient's plan paid $59, and the explanation of benefits from her insurance company

indicated that the patient was responsible for $75.

We provide dental services and our focus ¡s on delivering quality dental care. We are not a dental benefits

administrator and we do not have control over how much a particular patient's insurance will reimburse. Although it is

not our responsibility to know the detail of each patient's insurance policies, we would like to reach a mutually

acceptable resolution. We encourage the patient to contact the office to speak directly with Dr. Bower regarding her

concerns.

Sincerely,

Roanoke Valley Dental

Consumer

Response:

I have reviewed the response offer made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I did what they advised and spoke with Dr. Bower personally. She pointed out the fact that I mentioned how what they did was unethical and then attacked me stating that it was unethical of me to receive services and not pay for them. I have always paid my bills, medical included. I have never been so insulted by someone that doesn't even know me. No compromise or agreement was made. Just insults. I am more than disgusted.

Regards,