Smiles Dentistry

October 14, 2014This letter is in regards to the complaint dated October 8, in regards to our patient, *** *** at Smiles on ***, we take our patient's complaints and concerns very seriously, we strive to serve each of our patients with the highest quality of health
care experience possible, and take pride in committing to each of our patient's oral health.On July 7,2013, *** *** presented in our office for a *** Scaling and Root Planning procedure during two separate appointments, Prior to the patients visit our business assistance made the patient aware that his insurance would cover his treatment and his out of pocket cost to him would be $After submitting the patients insurance on his behalf the office was made aware that the Doctor was not in network with the patient insurance.We believe in the highest possible customer service and, therefore spoke to *** and his wife on 9/29/and advised that the doctor was not in network and the account will be credited the difference of the cost of treatment and the patient will be refunded $Patient and Spouse were both satisfied with the resolution,
Please feel free to contact me with any other questions or concerns, as we are eager to resolve any misunderstandingsSincerely
Brenda B
Practice Administrator

Review: I have [redacted] and [redacted] dental insurance. On May 30, 2014 I had my initial consultation with Smiles Dentristry of [redacted] located at [redacted] in [redacted], Maryland.I presented my [redacted] identification card to the receptionist who informed me that the doctors in the office were participating members with [redacted] and that Smiles would verify my dental coverage and benefits with [redacted]. During my next visit I was informed by Smiles finance representative that [redacted] would cover only $1,500.00 and that the three crowns I needed would cost approximately $5,800.00 and invisilign would cost another $4,000.00. I informed the representative that due to the limited coverage and cost of the crowns and invisilign that I would only agree to have the [redacted] scale & Root planing/quad done. The only service I received from Smiles was the [redacted] scale & Root planing/quad and during visits I paid co-payments as requested by Smiles. On July 15, 2014 I was also added to my wife's [redacted] dental plan. My wife and I immediately informed Smiles of this additional coverage, and on several occasions my wife provided Smiles the [redacted] identification card information and telephone number to verify my coverage under my wife's plan. During subsequent visits Smiles informed me and my wife that they were unable to verify [redacted] coverage and when my wife contacted [redacted] she was repeatedly informed that my coverage became effective July 15, 2014, and each time my wife informed Smiles of this information. Thereafter, I began receiving invoices from Smiles. I visited the office and my wife contacted Smiles inquiring about the charges of $320.00 as reflected in the 8/28/14 invoice. At that time I was informed by Tosha J[redacted] from the [redacted] Corporate office that the Dentist who performed the [redacted] scale&root planing/quad services was not a participating physician with [redacted] and I should not be held responsible for these charges because I was not informed prior to the services being performed.Desired Settlement: Today I received another invoiced from Smiles dated 9/24/14 reflecting a higher balance of $632.09 although my last visit was on or about July 30, 2014. I have been in communication with Ranika at Smiles in efforts to resolve this matter, to no avail. I am requesting that Smiles make the necessary billing adjustments so that any amounts not covered by [redacted] and [redacted], and amount that I have paid out of pocket be absorbed by Smiles and that I receive a final statement reflecting a zero balance

Business

Response:

October 14, 2014This letter is in regards to the complaint dated October 8, 2014 in regards to our patient, [redacted] at Smiles on [redacted], we take our patient's complaints and concerns very seriously, we strive to serve each of our patients with the highest quality of health care experience possible, and take pride in committing to each of our patient's oral health.On July 7,30 2013, [redacted] presented in our office for a [redacted] Scaling and Root Planning procedure during two separate appointments, Prior to the patients visit our business assistance made the patient aware that his insurance would cover his treatment and his out of pocket cost to him would be $272.80. After submitting the patients insurance on his behalf the office was made aware that the Doctor was not in network with the patient insurance.We believe in the highest possible customer service and, therefore spoke to [redacted] and his wife on 9/29/14 and advised that the doctor was not in network and the account will be credited the difference of the cost of treatment and the patient will be refunded $139.40. Patient and Spouse were both satisfied with the resolution,Please feel free to contact me with any other questions or concerns, as we are eager to resolve any misunderstandings.Sincerely Brenda BPractice Administrator