Sones Family Dental

Initial Business Response / [redacted] (1000, 5, 2015/07/20) */ The patient came into the office for a service that was performed and she is very happy with her result (as documented in her medical notes)Before the service was performed the patient was informed that the total fee for this service was dollars and we would send the claim to her insurance company (medicare)Our office policy was explained to her that we require 400$ down to start treatment and if the insurance pays the total fee the 400$ would be returned to the patient, if not, then the patient would be responsible for the remainder of the balance for the servicesThe patient was explained this and also signed a financial/insurance acknowledgement policy form stating thisHer claim was sent to her insurance carrier through our medical billing company GoGo INC the same day the service was performedSince then, Medicare has denied the claim and thus has been appealed (within days of the denial) with all paperwork/notes requested by Medicare insuranceThe patient has been informed of this on multiple occasionsMedicare has been contacted by both Gogo medical billing company and my officeCurrently we are still waiting on the appeal from her insurance carrier before/if we will reimburse the patientAlso, clearly stated in our financial policy, that we submit insurance as a courtesy to our patients but it is ultimately up to the patient as to the exact details of their planAll of which the patient has signed and been informed ofIf there should be such a complaint it should be to her medical insurance carrier as to the length of time between submitting the service, and waiting on the appealIf you need any other information, financial policy with patient signature, insurance acknowledgment or phone call notesplease do not hesitate to call the officeThanks

Initial Business Response /* (1000, 5, 2015/07/20) */
The patient came into the office for a service that was performed and she is very happy with her result (as documented in her medical notes). Before the service was performed the patient was informed that the total fee for this service was 2500...

dollars and we would send the claim to her insurance company (medicare). Our office policy was explained to her that we require 400$ down to start treatment and if the insurance pays the total fee the 400$ would be returned to the patient, if not, then the patient would be responsible for the remainder of the balance for the services. The patient was explained this and also signed a financial/insurance acknowledgement policy form stating this. Her claim was sent to her insurance carrier through our medical billing company GoGo INC the same day the service was performed. Since then, Medicare has denied the claim and thus has been appealed (within 5 days of the denial) with all paperwork/notes requested by Medicare insurance. The patient has been informed of this on multiple occasions. Medicare has been contacted by both Gogo medical billing company and my office. Currently we are still waiting on the appeal from her insurance carrier before/if we will reimburse the patient. Also, clearly stated in our financial policy, that we submit insurance as a courtesy to our patients but it is ultimately up to the patient as to the exact details of their plan. All of which the patient has signed and been informed of. If there should be such a complaint it should be to her medical insurance carrier as to the length of time between submitting the service, and waiting on the appeal. If you need any other information, financial policy with patient signature, insurance acknowledgment or phone call notes. please do not hesitate to call the office. Thanks