Steve M. Leighty DDS

1.) We estimated the insured's co-pay based on information received from *** ***A written estimate was given to Mrs***r on March 30, and her daughter's surgery was scheduled for April 17, We explained that this was an estimated co-pay; we would refund any overpayment on the
account or bill Mrs***r for any unpaid balanced once insurance claims were paid.2.) *** *** has a non-duplication of benefits clause which means that the secondary policy may not pay for duplicate expenses paid by the primary policyOur estimate was based on this clauseThe insured was given copies of the benefits clause from *** ***Both primary and secondary insurance policies were billed3.) The primary carrier has made two payments in the amount of $and $leaving a balance on the account of $4.) We contacted *** *** and the secondary claim is in processAs soon as we receive payment we will promptly refund the insured for any overpayment on the account

Review: My daughter is covered for all dental services by two dental plans and Dr. Leightys office staff provided me with a different estimate on the date my daughter was scheduled to have her wisdom teeth extracted. They told me Dental Dental does not pay under both plans. I refused to pay the new estimate because I could not imagine that they were correct. I paid the original estimate even though I didn't believe I should be paying out of pocket at all. First thing Monday morning I called [redacted] and was reassured that my plan, as the secondary provider, would pay for services after the primary paid. I was told it was all dependent upon coverage of services by each plan but usually if both plans cover up to 50% of the services that I shouldn't be paying out of pocket at all. I called Dr. Leightys office and explained what my insurance told me and asked how to get a refund. They said there is no guarantee the insurances will pay that way and I could call [redacted] and speak to 3 different people and get 3 different answers. I cannot believe this business can take my money when it seems they don't know or can't be bothered to learn how to bill insurance companies correctly. The custome service in the front end of this dental office is shameful!Desired Settlement: I want my $498.00 dollars back and Dr. Leightys office can bill my daughters primary and secondary insurance to pay for services rendered.

Business

Response:

1.) We estimated the insured's co-pay based on information received from [redacted]. A written estimate was given to Mrs. [redacted]r on March 30, 2015 and her daughter's surgery was scheduled for April 17, 2015. We explained that this was an estimated co-pay; we would refund any overpayment on the account or bill Mrs. [redacted]r for any unpaid balanced once insurance claims were paid.2.) [redacted] has a non-duplication of benefits clause which means that the secondary policy may not pay for duplicate expenses paid by the primary policy. Our estimate was based on this clause. The insured was given copies of the benefits clause from [redacted]. Both primary and secondary insurance policies were billed.3.) The primary carrier has made two payments in the amount of $100 and $1514.80 leaving a balance on the account of $277.20.4.) We contacted [redacted] and the secondary claim is in process. As soon as we receive payment we will promptly refund the insured for any overpayment on the account.

Consumer

Response:

I have reviewed the response made by the business in reference to my concern, and find that this resolution is satisfactory to me.