The Dental Specialists

Initial Business Response / [redacted] (1000, 5, 2015/11/12) */ Our operations coordinator contacted the patient on November 12th to apologize for our claim's submission errorShe explained that she had confirmed that his dental insurance company had received the refund for the incorrect check and they have corrected the error on his wife's benefitsShe also explained that she has stopped the billing statements to the patient and as a courtesy we would write-off his patient portion on the accountShe agreed with the patient's frustration regarding the length of time to resolve the claim issue and again apologizedThe patient indicated to her that he was satisfied with the resolution

Initial Business Response /* (1000, 7, 2015/05/26) */
We reviewed the patient complaint and the account detailsThe charges to the patient were accurate and were not changed from the original estimate as allegedHere is a summary of our response to the patientWe initially received a call
from the adult patient's father on May 8thThat is the same date as the father filed the complaint with the Revdex.comIt was explained to the father that the patient had exceeded his insurance maximum for the calendar year between the time that we provided the initial estimate and the date of the appointment at our officeIt was explained that billing from another provider's office may have processed in between the time of the estimate and the date of the surgeryThat is not something within our control and we encouraged him to contact his insurance company if he needed more information about thisAs a follto the call, we mailed copies of the relevant information to the patient's homeThe information included a copy of the HealthPartner's Claim Estimation Results that the patient signed on September 18, showing a patient responsibility of $This is the amount we collected from the patient on the date of the surgeryWe also sent a copy of a walkout statement showing that we billed the same treatment codes and fees as listed on the claims estimatorWe also included a written explanation of the same information conveyed to the patient's father over the telephoneThe HealthPartner's claims estimator showed that the insurance would pay $1,but they only paid $1,due to the patient hitting his $2,maximumWe also explained that we had a computer system conversion following the patient's appointment and we did not send out statements for a number of months while we verified the system dataWe apologized for any inconvenience in the delayed statements
In summary, the remaining balance of $is the patient's responsibility and we have done our best to explain this to the patient and to his father

We reviewed the patient complaint and the account details.  Our scheduling manager spoke with the patient regarding the initial billing to Delta Dental of Kentucky.  The patient never informed us that he had a secondary Medicaid coverage.  She also followed up with a Delta Dental...

representative to understand what Shawna from Delta had recommended to the patient.  Apparently she had recommended that we change the treatment code that the doctor had submitted.  That is not something that we would do as it was not an accurate treatment code.  The scheduling manager had then left a message for the patient to determine if Shawna from Delta had called him back and we never had feedback from the patient.  After learning that the patient had secondary coverage the doctor agreed to adjust off the $123 consultation fee as a courtesy.  The scheduling manager contacted him to discuss his concerns and to inform him of the adjustment on his account.  The patient wanted to extend a thank you and said that he is grateful for it.  We believe that this matter has been satisfactorily resolved. Sincerely, Jean [redacted] Director of Administration

We reviewed the patient complaint and the account details.  The Operations Coordinator has attempted to contact the patient on three occasions in the past week and there has been no response back.  We researched the account and found that it had been sent to collections but that was...

reversed and the account was paid in full.  The complaint references an oral surgery appointment on 06/13/14.  We do not have any record of an appointment on that date or with one of the oral surgeons.  We would be happy to address the patient’s account with her if she would respond back to us.

Initial Business Response /* (1000, 5, 2015/11/20) */
We reviewed the patient complaint and believe that this was a timing issue with when the patient received her statement and when the patient's dental insurance made their payment and the insurance adjustment was applied to the patient's account....

The patient was seen for dental care on 10/15/15 and we filed an insurance claim on her behalf. On 10/25/15 a statement was mailed to the patient showing the charges on the account and that an insurance claim had been filed. The patient's dental insurance payment was received by us on 11/02/15 and the contractual insurance adjustment was posted. This is the standard sequence for how insurance payments and adjustments are made on patient accounts. The patient filed her complaint with the Revdex.com on 11/10/15. We are sorry if she was confused about the insurance claim and payments. Our accounts receivable manager contacted her on 11/19/15 to confirm that the payment and insurance adjustment had already been posted to the account and the balance was paid in full. She also mailed the patient an account summary to confirm for her that this had been done.

Initial Business Response /* (1000, 5, 2015/11/12) */
Our operations coordinator contacted the patient on November 12th to apologize for our claim's submission error. She explained that she had confirmed that his dental insurance company had received the refund for the incorrect check and they...

have corrected the error on his wife's benefits. She also explained that she has stopped the billing statements to the patient and as a courtesy we would write-off his patient portion on the account. She agreed with the patient's frustration regarding the length of time to resolve the claim issue and again apologized. The patient indicated to her that he was satisfied with the resolution.