Smiles For Life

From: O***, Sheila Sent: Thursday, December 29, 12:PM To: info Subject: Case ID ***- *** * *** Response To whom it may concern, Mrs*** *** was seen in our office on 10/04/for SRP at that time we pulled her
insurance breakdown to see if they paid for all quads at once or only twoThe insurance states : Root Planning and scaling is payable once per quadrant in consecutive monthsSusan chose to do all quads in one sitting When we received the insurance payment the insurance paid for out of the quads stating on the EOB they only pay for quads We then resubmitted the claim back to insurance sending them back the insurance breakdown to which it states they will pay all once The insurance came back still denying the claim at that time The claim was closed, and the balance becomes the patient balance Mrs*** came in on 11/22/to have her teeth polished, and we took the time to review her eob from the insurance We explained everything to her giving her the insurance breakdown, eob and everything she needed to contact her insurance company to fight it on her ownWe explained to Mrs*** that we check her insurance as a courtesy but that it is her responsibility to know what her insurance covers When she left she stated that it was not our fault and she was sorry and that she would get it taken care of through her insurance We Thanked her for being a great patient and told her we would be happy to set up a payment plan on her balance. If you have any questions about our response to the complaint please do not hesitate to reach back out to us. Smiles For Life

To explain, before I followed through with scheduling my recent appointment, I provided my insurance to the receptionist who informed me that it was an accepted insurance provider Soon thereafter, not only did I receive two separate bills totaling over $for cleaning and x-rays that I did not need (my previous dentist confirmed this), but making matters worse, today I received another bill for over $1,of additional fees
I called the office and spoke with the finance manager, MsAmy C, who stated that she did not wish to place blame and "could not confirm the insurance policies of all of her patients." So I beg the question, why did I provide my insurance information if she did not bother to confirm the information?
To add injury to insult, MsC admitted that I was not the only person who "slipped through the cracks." Finally, when I explained to her that I would not have gone through with some of the procedures that were not critical due to finances, she responded with "we're all on a budget."
I am still dumbfounded as to this inferior quality of customer service
To date, no one from the office has reached out to me about this

Re: Case # [redacted] In regards to the complaint filed for case number [redacted], we take our patient’s concerns and complaints very seriously.  As a courtesy, we gather each patient’s insurance information and submit claims as needed.  Prior to treatment, our office provides and reviews treatment plans with our patients regarding their recommended treatment, as well as the fees for those procedures.  We let our patients know that all treatment plans are not a guarantee of benefits, if insurance does not pay the full portion, that balance will then be a responsibility of the patient.  Our mission is to provide lifetime care for all patients regardless of insurance coverage. Per our financial policy, payment is due at date of service. To accommodate this policy, we provide a variety of payment options for our patients.  Mrs. [redacted] has signed the attached financial policy stating she has agreed to these terms.  Dr. R[redacted]’s philosophy of care is to provide the best dental treatment.  He prides himself on professionalism and his relationship with his patients.  In sum, Dr. R[redacted] is confident that a high standard of care was met during the patient’s visits and that we handled her care appropriately.  I welcome the opportunity to provide any further information requested by the Revdex.com as a part of its inquiry into this matter.   Sincerely,     Business Team The Team at Smiles for Life

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
There are several glaring errors in the response from Smiles for Life.  First, I did NOT absolve them from responsibility.  What I apologized for was becoming agitated and upset about the bill.  I suffer from severe anxiety and panic attacks and to be billed for something THAT I WAS TOLD BY THEM WAS COVERED WAS VERY UPSETTING.  Second, I did say that I would discuss it with my insurance company and pursue the claim -- which I am doing through a currently active Revdex.com complaint where [redacted] has NOT yet responded.But, as regards this complaint against Smiles for Life ...I am, in effect, their guinea pig.  Because they lack any other clients with Retired Military -[redacted] Insurance, I am the one that is being penalized for their lack of familiarity with this insurance.  A dental provider that had multiple military retirees WOULD HAVE KNOWN not to schedule all four quads on the same day.  The fact remains that SMILES FOR LIFE gave me the option of having all four quads done in one day.  The moment they offered this, THEY voided my insurance and that is on them for not knowing better.  In addition to this current claim, there was another incident that happened at an earlier appointment.  On that day, they shined a light in my mouth to "screen for oral cancer" and then charged me $50 at the check-out.  THEY DID NOT INFORM me prior to the screening that it would cost me $50 and that it wasn't covered by my insurance.  So, I had to stand my ground and refuse to pay for a charge that I did not ask for when I went to check out.  After a minor argument, they agreed not to charge me.   So this has been a pattern of assuming I will pay for things out of pocket no question asked.  In other words, Smiles For Life is not being a good steward of my pocketbook...instead it seems they are trying to get every last dime out of me.I need to be able to trust my dentist and dental clinic that they KNOW what they are doing and have dealt with insurance ---MY INSURANCE COMPANY --- for years and have multiple patients with the same insurance.   I should have been told UP FRONT that they AREN'T familiar with my insurance company and don't know if they are doing things to void my insurance, then they need to take responsibility for voiding my insurance in this case.   The bottom line is that this procedure WAS covered, but it was voided because Smiles for Life did it all on the same day.  They are supposed to be the experts.   I NEVER in a million years would have agreed to this procedure if I thought for one minute that I would be financially responsible.  I was ASSURED BY THEM THAT IT WAS COVERED.  I don't take stupid chances like that when I know I can't pay for something.  Smiles For Life, however, seems to be ok with taking stupid chances on my behalf and at my expense.If Smiles for Life wants to really help, how about they continue to pursue the claim through the insurance company and contact additional agencies to help them with that? Because charging me for their mistake is not acceptable.     
Regards,
[redacted]