Smile Now Dental

Mr [redacted] presented to the office on 5/9/for his periodontal maintenanceThe office had just underwent a change of ownership from Dr [redacted] to SmileNOW Dental Group, starting May 1stDue to the fact that Mr [redacted] had a history of periodontal therapies over the years (starting 8/19/2013, in which periodontal scaling and root planning was started), a periodontal maintenance was performed by the associate doctor, Dr [redacted] , and billed to his dental insuranceAfter a patient has been through active periodontal therapy, all their subsequent recare visits are to be coded D4910, which is a periodontal maintenanceAccording to Mr [redacted] 's dental insurance carrier, periodontal maintenance falls under basic coverage, which is 80%, and he has a $deductible that applies to this categoryTherefore, he was responsible for his deductible plus 20% copayOnce payment from insurance was received, Mr [redacted] was sent a statement for his portionThere is documentation on 3/16/2015, by Dr [redacted] , of misunderstanding in part by Mr [redacted] of this procedure in the pastPeriodontal maintenance was performed on the following dates: 4/7/2014, and 12/15/According to Dr [redacted] ' notes, Mr [redacted] did not understand that all hygiene appointmehts after scaling and root planning are considered periodontal maintenanceSmileNOW Dental Group strives to provide our patients with the upmost in dental careWe also pride ourselves in helping patients utilize their dental insurance benefits, relieve them of the hassle of submitting their own claims by providing patients with the courtesy of billing directly to their dental insurance carriersIt is our responsibility to accurately code the procedures and treatment a patient is receivingTherefore, since Mr [redacted] is considered a patient with periodontal history, any future hygiene visits he has are to be treated as periodontal maintenancesThere was no error in billing on our part

I am rejecting this response because:There is no evidence of any previous scaling and root maintenanceI absolutely did NOT have any such procedure performed on the date in questionI had my teeth cleaned and flossedThey purposely billed it as a different procedure to get more money out of myself and/or insuranceIt is clear they are attempting to fraud the insurance as they completely neglected to mention the fact that they lied about Dr*** being present and that they failed to mention to me, as I have been requesting for the previous years that ANY out of pocket charges should be discussed with me prior to performing workI can see why Dr*** left

Mr. [redacted] presented to the office on 5/9/2017 for his periodontal maintenance. The office had just underwent a change of ownership from Dr. [redacted] to SmileNOW Dental Group, starting May 1st. Due to the fact that Mr. [redacted] had a history of periodontal therapies over the years (starting...

8/19/2013, in which periodontal scaling and root planning was started), a periodontal maintenance was performed by the associate doctor, Dr. [redacted], and billed to his dental insurance. After a patient has been through active periodontal therapy, all their subsequent recare visits are to be coded D4910, which is a periodontal maintenance. According to Mr. [redacted]'s dental insurance carrier, periodontal maintenance falls under basic coverage, which is 80%, and he has a $100 deductible that applies to this category. Therefore, he was responsible for his deductible plus 20% copay. Once payment from insurance was received, Mr. [redacted] was sent a statement for his portion. There is documentation on 3/16/2015, by Dr. [redacted], of misunderstanding in part by Mr. [redacted] of this procedure in the past. Periodontal maintenance was performed on the following dates: 4/7/2014, and 12/15/2014. According to Dr. [redacted]' notes, Mr. [redacted] did not understand that all hygiene appointmehts after scaling and root planning are considered periodontal maintenance. SmileNOW Dental Group strives to provide our patients with the upmost in dental care. We also pride ourselves in helping patients utilize their dental insurance benefits, relieve them of the hassle of submitting their own claims by providing patients with the courtesy of billing directly to their dental insurance carriers. It is our responsibility to accurately code the procedures and treatment a patient is receiving. Therefore, since Mr. [redacted] is considered a patient with periodontal history, any future hygiene visits he has are to be treated as periodontal maintenances. There was no error in billing on our part.