Smiles by Hart

Smiles by Hart has received the above Revdex.com patient complaint and appreciates the opportunity to respond. We understand [redacted] complaint states that Smiles by Hart falsely advertised for a free consultation but later billed her for the professional consultation that was provided on...

4/26/16.  A thorough review of the patient’s account shows no evidence of a written advertisement or her request for a free consultation at that time. Additionally, a careful review of our marketing files does not reveal any record of a free consultation being advertised during the month of April 2016.  Be assured that Smiles by Hart would take [redacted] request into consideration if such advertisement could still be made evident and of which she could provide.   At her 4/26/16 appointment, [redacted] provided Smiles by Hart with an active insurance plan and asked that her consultation be processed as such.  Smiles by Hart verified her benefits and has in-network participating provider status with the patient’s insurance carrier.  As a courtesy, an “estimated” insurance co-payment was given however, it was not a “guarantee” of payment in full.   At that time, the co-pay estimate, along with her verified insurance benefits, were reviewed with the patient prior to the service being provided.  The consultation was performed and in accordance with the patient’s insurance contract,  the estimated co-pay amount was collected from [redacted] at the time of service. Following her appointment, a timely dental insurance claim was prepared and submitted.  Upon receipt of the Explanation of Benefits (see attached) from her dental insurance carrier, it stated that the patient is responsible for the full fee of $95.00 since benefits were ultimately denied.  The amount owed is reflected in the bill the patient refers to in her statement. Smiles by Hart is not permitted contractually to alter/adjust/change this assignment of benefits as dictated by her specific insurance plan.  Additionally, upon initial registration, patient agreed / signed to be financially responsible for services rendered (see attached) and understood her responsibility to understand the extent and limits of her coverage.  Smiles by Hart makes every effort to advocate for the patient’s benefits, however, their insurance carrier has the ultimate decision as dictated by their specific plan and coverage. In summary, Smiles by Hart provided a service to this patient in good faith, verified and processed a claim for reimbursement on her behalf and finds no fault in the outstanding balance due by [redacted]. Should the Revdex.com require additional information please feel free to contact Smiles by Hart.