Thank you for giving our office a chance to rebut this complaint.? ? ? Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balanceMany times the patient should be frustrated with their insurance company not covering what their plan states they should coverInstead the frustration is directed at the dental office that is simply billing for a service Mrs [redacted] has stated she is upset that she had a remaining balance for procedure done January 20th Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with herPt states we never contacted her again and sent her to collections with no noticeHowever, we attempted to contact Mrs [redacted] more times than necessary before sending her to collectionsPt also believes she was “over charged for this procedure” The fee associated with the denture procedure is a contracted fee from her insurance company of $Our standard fee for that procedure is $770.? Due to our contract with the patient’s insurance company, she was allowed quite a large discountThe following is a statement from the patient’s Insurance Explanation of Benefits“This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a relineThe balance is the patient's responsibility”Mrs [redacted] ’s insurance company, Washington Dental Service, only paid $of their contracted fee of $We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us On 1/26/Mrs [redacted] paid $on the date of serviceThis payment was for the interim partial denture, an extraction and Nitrous Oxide.? Mrs [redacted] was sent a bill of $on 2/5/with a small note explaining remaining portion of the interim partial denture that her insurance did not coverThe patient was sent the same bill for $on 3/10/and again on 4/14/Mrs [redacted] was sent her 1st collections letter on 4/15/which simply is letting them know their account is overdueMrs [redacted] was sent another bill for $on 5/14/and was sent her 2nd collections letter on 5/15/stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay accountOn 6/2/15, Mrs [redacted] called to schedule her husband, and also wanted to know why she had a billCrystal explained that insurance had paid less than they had originally said they would, leaving her with a balance.? She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to payShe said she'd call her insurance and she wanted a copy of her breakdownOn 6/8/spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, [redacted] said she would callPatient was sent a bill on 6/23/with another 1st collections letterOn 6/29/while [redacted] was in the office getting treatment we spoke with him regarding balance [redacted] stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments.? Mrs [redacted] was sent a bill on 7/28/for $due to an additional $from her husband [redacted] not paying his patient portion in full when he came in for his treatment on 6/29/She was also sent collections letter #along with that billOn 9/1/Pt was sent her 3rd and final collections letterPt was sent a bill on 10/14/as well as on 11/23/As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs [redacted] Actually we let it drag out too longAs an added side note: when we send an account to collections we have it set up where the patients have days to pay their account before it negatively affects their credit Thank you for your time, Natasha C [redacted] Office Manager
Thank you for giving our office a chance to rebut this complaint Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balanceMany times the patient should be frustrated with their insurance company not covering what their plan states they should coverInstead the frustration is directed at the dental office that is simply billing for a service Mrs [redacted] has stated she is upset that she had a remaining balance for procedure done January 20th Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with herPt states we never contacted her again and sent her to collections with no noticeHowever, we attempted to contact Mrs [redacted] more times than necessary before sending her to collectionsPt also believes she was “over charged for this procedure” The fee associated with the denture procedure is a contracted fee from her insurance company of $Our standard fee for that procedure is $ Due to our contract with the patient’s insurance company, she was allowed quite a large discountThe following is a statement from the patient’s Insurance Explanation of Benefits“This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a relineThe balance is the patient's responsibility”Mrs [redacted] ’s insurance company, Washington Dental Service, only paid $of their contracted fee of $We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us On 1/26/Mrs [redacted] paid $on the date of serviceThis payment was for the interim partial denture, an extraction and Nitrous Oxide Mrs [redacted] was sent a bill of $on 2/5/with a small note explaining remaining portion of the interim partial denture that her insurance did not coverThe patient was sent the same bill for $on 3/10/and again on 4/14/Mrs [redacted] was sent her 1st collections letter on 4/15/which simply is letting them know their account is overdueMrs [redacted] was sent another bill for $on 5/14/and was sent her 2nd collections letter on 5/15/stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay accountOn 6/2/15, Mrs [redacted] called to schedule her husband, and also wanted to know why she had a billCrystal explained that insurance had paid less than they had originally said they would, leaving her with a balance She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to payShe said she'd call her insurance and she wanted a copy of her breakdownOn 6/8/spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, [redacted] said she would callPatient was sent a bill on 6/23/with another 1st collections letterOn 6/29/while [redacted] was in the office getting treatment we spoke with him regarding balance [redacted] stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments Mrs [redacted] was sent a bill on 7/28/for $due to an additional $from her husband [redacted] not paying his patient portion in full when he came in for his treatment on 6/29/She was also sent collections letter #along with that billOn 9/1/Pt was sent her 3rd and final collections letterPt was sent a bill on 10/14/as well as on 11/23/As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs [redacted] Actually we let it drag out too longAs an added side note: when we send an account to collections we have it set up where the patients have days to pay their account before it negatively affects their credit Thank you for your time, Natasha C [redacted] Office Manager
Complaint: ***I am rejecting this response because: The amount I paid up front was NEVER stated as an estimateI was told at the time I booked the appointment what I would need to payI paid the exact amount due when I came in for treatmentI am not the only client under the care of Elma Family Dental with this complaintMy dental insurance is one of the best and most highly acceptedI have never been more disgusted by the treatment from this office staff.
Sincerely,*** ***
Thank you for giving our office a chance to rebut this complaint.
Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balanceMany times the
patient should be frustrated with their insurance company not covering what their plan states they should coverInstead the frustration is directed at the dental office that is simply billing for a service
Mrs*** has stated she is upset that she had a remaining balance for procedure done January 20th Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with herPt states we never contacted her again and sent her to collections with no noticeHowever, we attempted to contact Mrs*** more times than necessary before sending her to collectionsPt also believes she was “over charged for this procedure”
The fee associated with the denture procedure is a contracted fee from her insurance company of $Our standard fee for that procedure is $770. Due to our contract with the patient’s insurance company, she was allowed quite a large discountThe following is a statement from the patient’s Insurance Explanation of Benefits“This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a relineThe balance is the patient's responsibility”Mrs***’s insurance company, Washington Dental Service, only paid $of their contracted fee of $We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us
On 1/26/Mrs*** paid $on the date of serviceThis payment was for the interim partial denture, an extraction and Nitrous Oxide. Mrs*** was sent a bill of $on 2/5/with a small note explaining remaining portion of the interim partial denture that her insurance did not coverThe patient was sent the same bill for $on 3/10/and again on 4/14/Mrs*** was sent her 1st collections letter on 4/15/which simply is letting them know their account is overdueMrs*** was sent another bill for $on 5/14/and was sent her 2nd collections letter on 5/15/stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay accountOn 6/2/15, Mrs*** called to schedule her husband, and also wanted to know why she had a billCrystal explained that insurance had paid less than they had originally said they would, leaving her with a balance. She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to payShe said she'd call her insurance and she wanted a copy of her breakdownOn 6/8/spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, *** said she would callPatient was sent a bill on 6/23/with another 1st collections letterOn 6/29/while *** was in the office getting treatment we spoke with him regarding balance*** stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments. Mrs*** was sent a bill on 7/28/for $due to an additional $from her husband *** not paying his patient portion in full when he came in for his treatment on 6/29/She was also sent collections letter #along with that billOn 9/1/Pt was sent her 3rd and final collections letterPt was sent a bill on 10/14/as well as on 11/23/As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs***Actually we let it drag out too longAs an added side note: when we send an account to collections we have it set up where the patients have days to pay their account before it negatively affects their credit
Thank you for your time,
Natasha C***
Office Manager
Complaint: [redacted]I am rejecting this response because: The amount I paid up front was NEVER stated as an estimate. I was told at the time I booked the appointment what I would need to pay. I paid the exact amount due when I came in for treatment. I am not the only client under the care of Elma Family Dental with this complaint. My dental insurance is one of the best and most highly accepted. I have never been more disgusted by the treatment from this office staff.
Sincerely,[redacted]
Thank you for giving our office a chance to rebut this complaint.
Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balance. Many times the...
patient should be frustrated with their insurance company not covering what their plan states they should cover. Instead the frustration is directed at the dental office that is simply billing for a service.
Mrs. [redacted] has stated she is upset that she had a remaining balance for procedure done January 20th 2015. Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with her. Pt states we never contacted her again and sent her to collections with no notice. However, we attempted to contact Mrs. [redacted] more times than necessary before sending her to collections. Pt also believes she was “over charged for this procedure”.
The fee associated with the denture procedure is a contracted fee from her insurance company of $455. Our standard fee for that procedure is $770. Due to our contract with the patient’s insurance company, she was allowed quite a large discount. The following is a statement from the patient’s Insurance Explanation of Benefits. “This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a reline. The balance is the patient's responsibility”. Mrs. [redacted]’s insurance company, Washington Dental Service, only paid $112 of their contracted fee of $455. We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us.
On 1/26/15 Mrs. [redacted] paid $327.30 on the date of service. This payment was for the interim partial denture, an extraction and Nitrous Oxide. Mrs. [redacted] was sent a bill of $90.50 on 2/5/15 with a small note explaining remaining portion of the interim partial denture that her insurance did not cover. The patient was sent the same bill for $90.50 on 3/10/15 and again on 4/14/15. Mrs. [redacted] was sent her 1st collections letter on 4/15/15 which simply is letting them know their account is overdue. Mrs. [redacted] was sent another bill for $90.50 on 5/14/15 and was sent her 2nd collections letter on 5/15/15 stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay account. On 6/2/15, Mrs. [redacted] called to schedule her husband, and also wanted to know why she had a bill. Crystal explained that insurance had paid less than they had originally said they would, leaving her with a balance. She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to pay. She said she'd call her insurance and she wanted a copy of her breakdown. On 6/8/15 spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, [redacted] said she would call. Patient was sent a bill on 6/23/15 with another 1st collections letter. On 6/29/15 while [redacted] was in the office getting treatment we spoke with him regarding balance. [redacted] stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments. Mrs. [redacted] was sent a bill on 7/28/15 for $138.70 due to an additional $48.20 from her husband [redacted] not paying his patient portion in full when he came in for his treatment on 6/29/15. She was also sent collections letter #2 along with that bill. On 9/1/15 Pt was sent her 3rd and final collections letter. Pt was sent a bill on 10/14/15 as well as on 11/23/15. As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs. [redacted]. Actually we let it drag out too long. As an added side note: when we send an account to collections we have it set up where the patients have 30 days to pay their account before it negatively affects their credit.
Thank you for your time,
Natasha C[redacted]
Office Manager
Thank you for giving our office a chance to rebut this complaint.? ? ? Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balanceMany times the patient should be frustrated with their insurance company not covering what their plan states they should coverInstead the frustration is directed at the dental office that is simply billing for a service Mrs [redacted] has stated she is upset that she had a remaining balance for procedure done January 20th Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with herPt states we never contacted her again and sent her to collections with no noticeHowever, we attempted to contact Mrs [redacted] more times than necessary before sending her to collectionsPt also believes she was “over charged for this procedure” The fee associated with the denture procedure is a contracted fee from her insurance company of $Our standard fee for that procedure is $770.? Due to our contract with the patient’s insurance company, she was allowed quite a large discountThe following is a statement from the patient’s Insurance Explanation of Benefits“This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a relineThe balance is the patient's responsibility”Mrs [redacted] ’s insurance company, Washington Dental Service, only paid $of their contracted fee of $We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us On 1/26/Mrs [redacted] paid $on the date of serviceThis payment was for the interim partial denture, an extraction and Nitrous Oxide.? Mrs [redacted] was sent a bill of $on 2/5/with a small note explaining remaining portion of the interim partial denture that her insurance did not coverThe patient was sent the same bill for $on 3/10/and again on 4/14/Mrs [redacted] was sent her 1st collections letter on 4/15/which simply is letting them know their account is overdueMrs [redacted] was sent another bill for $on 5/14/and was sent her 2nd collections letter on 5/15/stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay accountOn 6/2/15, Mrs [redacted] called to schedule her husband, and also wanted to know why she had a billCrystal explained that insurance had paid less than they had originally said they would, leaving her with a balance.? She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to payShe said she'd call her insurance and she wanted a copy of her breakdownOn 6/8/spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, [redacted] said she would callPatient was sent a bill on 6/23/with another 1st collections letterOn 6/29/while [redacted] was in the office getting treatment we spoke with him regarding balance [redacted] stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments.? Mrs [redacted] was sent a bill on 7/28/for $due to an additional $from her husband [redacted] not paying his patient portion in full when he came in for his treatment on 6/29/She was also sent collections letter #along with that billOn 9/1/Pt was sent her 3rd and final collections letterPt was sent a bill on 10/14/as well as on 11/23/As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs [redacted] Actually we let it drag out too longAs an added side note: when we send an account to collections we have it set up where the patients have days to pay their account before it negatively affects their credit Thank you for your time, Natasha C [redacted] Office Manager
Thank you for giving our office a chance to rebut this complaint Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balanceMany times the patient should be frustrated with their insurance company not covering what their plan states they should coverInstead the frustration is directed at the dental office that is simply billing for a service Mrs [redacted] has stated she is upset that she had a remaining balance for procedure done January 20th Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with herPt states we never contacted her again and sent her to collections with no noticeHowever, we attempted to contact Mrs [redacted] more times than necessary before sending her to collectionsPt also believes she was “over charged for this procedure” The fee associated with the denture procedure is a contracted fee from her insurance company of $Our standard fee for that procedure is $ Due to our contract with the patient’s insurance company, she was allowed quite a large discountThe following is a statement from the patient’s Insurance Explanation of Benefits“This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a relineThe balance is the patient's responsibility”Mrs [redacted] ’s insurance company, Washington Dental Service, only paid $of their contracted fee of $We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us On 1/26/Mrs [redacted] paid $on the date of serviceThis payment was for the interim partial denture, an extraction and Nitrous Oxide Mrs [redacted] was sent a bill of $on 2/5/with a small note explaining remaining portion of the interim partial denture that her insurance did not coverThe patient was sent the same bill for $on 3/10/and again on 4/14/Mrs [redacted] was sent her 1st collections letter on 4/15/which simply is letting them know their account is overdueMrs [redacted] was sent another bill for $on 5/14/and was sent her 2nd collections letter on 5/15/stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay accountOn 6/2/15, Mrs [redacted] called to schedule her husband, and also wanted to know why she had a billCrystal explained that insurance had paid less than they had originally said they would, leaving her with a balance She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to payShe said she'd call her insurance and she wanted a copy of her breakdownOn 6/8/spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, [redacted] said she would callPatient was sent a bill on 6/23/with another 1st collections letterOn 6/29/while [redacted] was in the office getting treatment we spoke with him regarding balance [redacted] stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments Mrs [redacted] was sent a bill on 7/28/for $due to an additional $from her husband [redacted] not paying his patient portion in full when he came in for his treatment on 6/29/She was also sent collections letter #along with that billOn 9/1/Pt was sent her 3rd and final collections letterPt was sent a bill on 10/14/as well as on 11/23/As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs [redacted] Actually we let it drag out too longAs an added side note: when we send an account to collections we have it set up where the patients have days to pay their account before it negatively affects their credit Thank you for your time, Natasha C [redacted] Office Manager
Complaint: ***I am rejecting this response because: The amount I paid up front was NEVER stated as an estimateI was told at the time I booked the appointment what I would need to payI paid the exact amount due when I came in for treatmentI am not the only client under the care of Elma Family Dental with this complaintMy dental insurance is one of the best and most highly acceptedI have never been more disgusted by the treatment from this office staff.
Sincerely,*** ***
Thank you for giving our office a chance to rebut this complaint.
Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balanceMany times the
patient should be frustrated with their insurance company not covering what their plan states they should coverInstead the frustration is directed at the dental office that is simply billing for a service
Mrs*** has stated she is upset that she had a remaining balance for procedure done January 20th Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with herPt states we never contacted her again and sent her to collections with no noticeHowever, we attempted to contact Mrs*** more times than necessary before sending her to collectionsPt also believes she was “over charged for this procedure”
The fee associated with the denture procedure is a contracted fee from her insurance company of $Our standard fee for that procedure is $770. Due to our contract with the patient’s insurance company, she was allowed quite a large discountThe following is a statement from the patient’s Insurance Explanation of Benefits“This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a relineThe balance is the patient's responsibility”Mrs***’s insurance company, Washington Dental Service, only paid $of their contracted fee of $We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us
On 1/26/Mrs*** paid $on the date of serviceThis payment was for the interim partial denture, an extraction and Nitrous Oxide. Mrs*** was sent a bill of $on 2/5/with a small note explaining remaining portion of the interim partial denture that her insurance did not coverThe patient was sent the same bill for $on 3/10/and again on 4/14/Mrs*** was sent her 1st collections letter on 4/15/which simply is letting them know their account is overdueMrs*** was sent another bill for $on 5/14/and was sent her 2nd collections letter on 5/15/stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay accountOn 6/2/15, Mrs*** called to schedule her husband, and also wanted to know why she had a billCrystal explained that insurance had paid less than they had originally said they would, leaving her with a balance. She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to payShe said she'd call her insurance and she wanted a copy of her breakdownOn 6/8/spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, *** said she would callPatient was sent a bill on 6/23/with another 1st collections letterOn 6/29/while *** was in the office getting treatment we spoke with him regarding balance*** stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments. Mrs*** was sent a bill on 7/28/for $due to an additional $from her husband *** not paying his patient portion in full when he came in for his treatment on 6/29/She was also sent collections letter #along with that billOn 9/1/Pt was sent her 3rd and final collections letterPt was sent a bill on 10/14/as well as on 11/23/As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs***Actually we let it drag out too longAs an added side note: when we send an account to collections we have it set up where the patients have days to pay their account before it negatively affects their credit
Thank you for your time,
Natasha C***
Office Manager
Complaint: [redacted]I am rejecting this response because: The amount I paid up front was NEVER stated as an estimate. I was told at the time I booked the appointment what I would need to pay. I paid the exact amount due when I came in for treatment. I am not the only client under the care of Elma Family Dental with this complaint. My dental insurance is one of the best and most highly accepted. I have never been more disgusted by the treatment from this office staff.
Sincerely,[redacted]
Thank you for giving our office a chance to rebut this complaint.
Unfortunately, insurance companies, like Washington Dental Service, utilize loopholes to avoid paying out full benefits for their consumers; leaving the consumer/patient with an outstanding balance. Many times the...
patient should be frustrated with their insurance company not covering what their plan states they should cover. Instead the frustration is directed at the dental office that is simply billing for a service.
Mrs. [redacted] has stated she is upset that she had a remaining balance for procedure done January 20th 2015. Pt states that she was told we would contact her insurance again in regards to why she was left with a balance and follow up with her. Pt states we never contacted her again and sent her to collections with no notice. However, we attempted to contact Mrs. [redacted] more times than necessary before sending her to collections. Pt also believes she was “over charged for this procedure”.
The fee associated with the denture procedure is a contracted fee from her insurance company of $455. Our standard fee for that procedure is $770. Due to our contract with the patient’s insurance company, she was allowed quite a large discount. The following is a statement from the patient’s Insurance Explanation of Benefits. “This contract provides for reimbursement of an interim partial or interim complete denture up to the allowance of a reline. The balance is the patient's responsibility”. Mrs. [redacted]’s insurance company, Washington Dental Service, only paid $112 of their contracted fee of $455. We initially estimated it would cover 50% of the procedure because we did not know about this loophole until the insurance sent the payment and informed us.
On 1/26/15 Mrs. [redacted] paid $327.30 on the date of service. This payment was for the interim partial denture, an extraction and Nitrous Oxide. Mrs. [redacted] was sent a bill of $90.50 on 2/5/15 with a small note explaining remaining portion of the interim partial denture that her insurance did not cover. The patient was sent the same bill for $90.50 on 3/10/15 and again on 4/14/15. Mrs. [redacted] was sent her 1st collections letter on 4/15/15 which simply is letting them know their account is overdue. Mrs. [redacted] was sent another bill for $90.50 on 5/14/15 and was sent her 2nd collections letter on 5/15/15 stating we would need to take more aggressive action if the patient doesn’t set up arrangements to pay account. On 6/2/15, Mrs. [redacted] called to schedule her husband, and also wanted to know why she had a bill. Crystal explained that insurance had paid less than they had originally said they would, leaving her with a balance. She said "but I signed that thing with the 'agreed upon' price" Crystal reminded her that was an estimate, and that we can never predict what an insurance is actually going to pay. She said she'd call her insurance and she wanted a copy of her breakdown. On 6/8/15 spoke with patient and she still hasn't called insurance, Crystal again explained that insurance downgraded the flipper fee to that of a reline, [redacted] said she would call. Patient was sent a bill on 6/23/15 with another 1st collections letter. On 6/29/15 while [redacted] was in the office getting treatment we spoke with him regarding balance. [redacted] stated that his wife spoke with the insurance company today and they know they have to pay the interim denture fee and they will be making payments. Mrs. [redacted] was sent a bill on 7/28/15 for $138.70 due to an additional $48.20 from her husband [redacted] not paying his patient portion in full when he came in for his treatment on 6/29/15. She was also sent collections letter #2 along with that bill. On 9/1/15 Pt was sent her 3rd and final collections letter. Pt was sent a bill on 10/14/15 as well as on 11/23/15. As you can see with the documentation I have provided, we went above and beyond in regards to trying to contact Mrs. [redacted]. Actually we let it drag out too long. As an added side note: when we send an account to collections we have it set up where the patients have 30 days to pay their account before it negatively affects their credit.
Thank you for your time,
Natasha C[redacted]
Office Manager