Ronald B Carmen, DDS

I reviewed the response made by the business in reference to complaint ID ***, and find the resolution is satisfactory to me
Regards,
*** ***

We apologize for [redacted]'s misunderstanding at the time of his consultation.  He is correct that he was offered and given a complimentary consultation. A fee with our office was only incurred  after [redacted] elected to proceed with orthodontic recommendations for his son.  Only at...

that point, [redacted] signed a financial contract, consent forms and made payment arrangements with our office for his son's diagnostic records, spacers and appliance.  The "orthodontic records" and placement of spacers was completed on 4/8/2015 after [redacted] elected to proceed with his son's treatment.  [redacted] was accurately told that this non-refundable service had been completed on 4/8/2015, however he was relieved of commitment to pay for any future scheduled services/appliance fee.Although the paid-for-services were already completed by our office, we have agreed to [redacted]'s request for a $300.00 refund.  That refund will be processed this week with a check being sent to [redacted], but our office will keep any insurance payment received from [redacted] for those services which were rendered on 4/8/2015. Thank you,[redacted]

Review: The brochure states that "following the tour, you will receive a thorough complimentary examination, including x-rays." I am a State of Ohio employee; I have [redacted] insurance which should have covered any charges because I have already paid my ($25) deductible for the year. I was referred to [redacted] simply to find out if my 9 y/o son was ready for braces. During the consultation, the Dr. advised that he is not ready for braces, but suggested an "appliance" might help. They asked me for $650 up front for the treatment. I paid $300 the same day (4/8/15). I visited another Orthodontist for a 2nd opinion who suggested that the appliance would not be needed; and, ultimately decided to go with the 2nd opinion facility. I returned to [redacted] to have my $300 refunded because they have not performed any service or provided any product outside of the complimentary exam. They have refused to return my $300. They stated that on 4/8/15 they also took a cast of my son's teeth; they are calling the cast "dental records". On my initial visit to [redacted], I DID NOT REQUEST ANY DENTAL RECORDS TO BE MADE OF MY SON'S TEETH. I simply wanted to know if my son was ready for braces.Desired Settlement: I want my $300.00 refunded.

Business

Response:

We apologize for [redacted]'s misunderstanding at the time of his consultation. He is correct that he was offered and given a complimentary consultation. A fee with our office was only incurred after [redacted] elected to proceed with orthodontic recommendations for his son. Only at that point, [redacted] signed a financial contract, consent forms and made payment arrangements with our office for his son's diagnostic records, spacers and appliance. The "orthodontic records" and placement of spacers was completed on 4/8/2015 after [redacted] elected to proceed with his son's treatment. [redacted] was accurately told that this non-refundable service had been completed on 4/8/2015, however he was relieved of commitment to pay for any future scheduled services/appliance fee.

On 12/9/2010 we took our 2 children into Dr. [redacted]'s Pickerington office for a free consultation. Our 9 yr old son had been to the regular dentist the week before & an ortho consult was advised. We met w/[redacted], a Treatment Coordinator & discussed our concerns. [redacted] stated the office would take complimentary photos, panaramic shots & x-rays of our children's mouths in order to help determine the course of treatment.

During that time I stated to her that our son had just had x-rays and photos taken the week prior at our dentists office & was told not to worry, this is all complimentary & no charge. After the photos, x-rays, etc., we were shown the images on a computer in a private office. [redacted] indicated our children would need braces & our son would need something for his grinding & that Dr. [redacted] would be in to discuss appropriate treatment(s).

Dr. [redacted] stated our sons molars were "smooth as tabletops" & that it was important to get a device to avoid further damage to his teeth & gums. We were told the appliance our son needed was a guard he would wear at night, the cost of the appliance was $650.00. We were told that our insurance covered 75% & that our out of pocket cost would be $650.00 that must be paid before we were able to have the device because insurance won't pay anything until the device is installed.

We were told the insurance company would then mail us a check for $650.00 minus the difference from the cost of the device vs. what our insurance covered. We were told our balance after insurance was $162.50 (a reimbursement of $487.50 would be coming). I stated I had never had to pay anything up front like this before & was told by [redacted] that this is how orthodontics works.

Noting that our son required this device sooner rather than later, we went forward & paid the initial $325.00 that day & the balance on 12/19/2011 the day we picked up the appliance.

On 1/11/2012, I called our insurance company ([redacted] Dental) & was informed that the check was sent to Dr. [redacted]'s office per policy & the amount of the check was $444.50. I inquired as to the different refund amount & [redacted] with [redacted] Dental stated the claim was made up of the following charges for our son: panoramic x-ray $85.00, cephalogram film $95.00, photos $60.00, study models $60.00, a mouth guard $350.00. The claim totals $650.00.

I was shocked to discover the items we were told were done "complimentary" were now part of an insurance claim. We were told the cost of the guard was $650.00. [redacted] Dental stated this dentist is part of the premiere plan & per the contract could not charge us more than 25% of the appliance at the time of service. The entire claim should have been for $410.00 - the cost of the guard & study models. We should have only been charged 25% of the cost of the appliance itself. The complimentary items should not have been charged to our insurance.

I contacted the office, spoke with [redacted] who was very rude & condescending. She told me I didn't understand billing codes & that the cost for this appliance is $650.00, she then stated the entire treatment is $650.00 after I told her what my insurance company said. [redacted] stated she has been doing this for 30+ yrs and this is just how it is. I continued to question the charges for the complimentary services & got no where.

I requested a 3 way call w/my insurance company, [redacted] scoffed stating she would not initiate that call but that I could. I called [redacted] Dental & then conference called [redacted]. She put the call on speaker announcing that [redacted] the billing person was now on the call as well. [redacted] restated the policy of charging patients in full up front & was told by the insurance rep. that that was not allowed under the contract, reiterating we were erroneously billed an exorbitant amount up front. [redacted] eventually conceded & agreed to refund the difference but refused to correct the amount of claim. At the end of the call [redacted] stated,"wow what a ([redacted])" in reference to me.