The Smile Center of Mount Holly

Regarding complaint*** *** RE: The Smile CenterMrs*** came to the office for the first time on 8/20/She states that she was given a treatmentplan under her insurance *** ***This is true.The office procedure, which is strictly followed, regularly trained on and
enforced is that allpatients are made aware that if their insurance company does not coverposterior composites they are responsible for the differenceIt is repeatedlyand strongly advised to the patients that our estimates are exactly that,estimatesEven when copays and coinsurance are collected the front deskrequests, “Your estimated copay for today is $X.XX, how would you like to payfor that?”If the patient would like a more accurate estimate we make them aware that we can, at their request,send a predetermination to their insurance companyFurthermore, there is avery conspicuous sign in our waiting room that clearly reads, “Unless otherwiseindicated by the patient our office will only be placing composite (white)fillingsPlease inform the doctor if you would like amalgam (silver)fillings.”Mrs*** also states that “…staff ar/ap who presents you with treatment information is aware ofbilling costs and made me aware of what my insurance covered and did not coverEXCEPT for a enamel filling of my posterior tooth following a root canalI wasnever informed that this was NOT covered by my insurance until I came in fortreatment of another tooth at which point I was informed I was responsible forthe entirety of the procedure.”She was not ever held responsible for the entire procedureOf the $charge the insurance paid $88and she was responsible for $of which she paid, as she mentioned, $Inaddition, she did not pay her copay for the root canal she mentioned on 8/20/13(in the *** office) which totaled $This left her with an initialbalance from both procedures of $167.She was sent statements from the *** office on 8/27/13, 9/17/13, 10/7/13, 10/28/and 11/19/13.She was sent statements from the *** *** office on 11/8/13, 12/20/and2/21/These bills were followed up by a phone call on 3/10/to her homenumber where a message was leftThen she was sent a collection letter on3/28/which detailed the two balances which included the previous $andfinance charges in the a*** of $This letter stated,“We recently reviewed your financial status andwere surprised by your lack of response to our numerous attempts to collectfinal payment for treatment you received.According to our records, your remaining balance of $ includes interest in the a*** of$on charges accrued in our *** *** and *** Offices. Pleasecheck your records and contact us immediately if they do not match ours, so wecan correct any discrepancy.If your records agree with ours, we regard this as a very serious situationWe certainly do not wishto be forced to seek other recourse to collect the money owedWe want tocommunicate with youIf we do not hear from you within days, we will turnyour account over to a collection agency“We turned her account over to the ***, a (** *** *** ***) collection agency, on 5/23/14at which point our attempts to collect the debt were ceasedAt that point, aswas clearly defined in the Patient Liability Agreement she signed on 8/20/13, a35% collection fee (as defined by the balance of the bill due divided by .65)was added to her current balance (as of that date $179.13) which brought herbalance to $She states that she “talked to the company” on 2/24/and 2/18/She has never contacted ouroffice regarding the multiple statements she has been sent, nor returned thephone call that was made to discuss the debtThe only interaction the officehad with Mrs*** since the collection letter was sent from our office wastwo days ago 2/23/when Mrs*** sent us a fax stating her complaint andthat if we did not resolve it by only making her pay $she would complainto the Revdex.comWe were still in the process of reviewing the information that wasreceived less than hours before she made her complaint to you.The patient would like us to “eat the charges” for a procedure she agreed to have done and collectionfees that she agreed to in writing when she has never made an effort to resolvethis debt or dispute it with our officeWe would be happy to discuss thesituation and the possibility of reducing the original debt but the collection fees were incurred due to thefact that she ignored our attempts to collect or resolve the debt and thecollection agency will not waive them.Sincerely,*** ***Practice Manager*** *** *** ** *** *** *** *** *** *** *** *** ** ***###-###-####

Review: I went to The Smile Center of Mt Holly in Fall of 2013. I was given a plan of treatment under my insurance ([redacted]). Their staff ar/ap who presents you with treatment information is aware of billing costs and made me aware of what my insurance covered and did not cover EXCEPT for a enamel filling of my posterior tooth following a root canal. I was never informed that this was NOT covered by my insurance until I came in for treatment of another tooth at which point I was informed I was responsible for the entirety of the procedure. Amalgam fillings were an option and one I would have been willing to choose had I been informed that the former was not covered. In fact, I was never even informed of what type of filling they would be using. Shortly after I received a bill for $122. Then an addition bill of $122 plus 3 processing charges of $1.76. That bill was my "FINAL NOTICE" at which point I was sent to collections. The man who they hired to collect was apparently unaware of the law as he CALLED MY PLACE OF EMPLOYMENT informing them of his intent to collect a debt. he also stated that I owed [redacted] over $200 (I think its $270). He said had I paid the bill in the beginning it would have only been $170? I was promised that the Office Mgr would call me, she never has. I've faxed over copies of my final bill and notices showing final costs and still no one has called me. They caused me to incur charges by performing a service with UNINFORMED consent then to add insult to injury embarrassed me with my employer with their unethical collection and billing practices.Desired Settlement: They either need to eat the charges themselves or honor their original bill which I still would be unhappy with but better than what they are claiming I owe through collections. I refuse to pay $200 plus in charges that I did not even give proper consent for. They are unprofessional and unethical in terms of billing. They need to make their patients aware of all charges that could be incurred not after the procedure has been performed so the patient can decide what is a better option for them. I am a 28 year old who provides for my disabled mother. I would obviously make the choice of whatever my insurance covered at 100% not what cost, in the end, almost $300 (though that in and of itself is BS seeing as I have the final bill stating the $122).

Business

Response:

Regarding complaint[redacted] RE: The Smile CenterMrs. [redacted] came to the office for the first time on 8/20/13. She states that she was given a treatmentplan under her insurance [redacted]. This is true.The office procedure, which is strictly followed, regularly trained on and enforced is that allpatients are made aware that if their insurance company does not coverposterior composites they are responsible for the difference. It is repeatedlyand strongly advised to the patients that our estimates are exactly that,estimates. Even when copays and coinsurance are collected the front deskrequests, “Your estimated copay for today is $X.XX, how would you like to payfor that?”If the patient would like a more accurate estimate we make them aware that we can, at their request,send a predetermination to their insurance company. Furthermore, there is avery conspicuous sign in our waiting room that clearly reads, “Unless otherwiseindicated by the patient our office will only be placing composite (white)fillings. Please inform the doctor if you would like amalgam (silver)fillings.”Mrs. [redacted] also states that “…staff ar/ap who presents you with treatment information is aware ofbilling costs and made me aware of what my insurance covered and did not coverEXCEPT for a enamel filling of my posterior tooth following a root canal. I wasnever informed that this was NOT covered by my insurance until I came in fortreatment of another tooth at which point I was informed I was responsible forthe entirety of the procedure.”She was not ever held responsible for the entire procedure. Of the $255 charge the insurance paid $88and she was responsible for $167 of which she paid, as she mentioned, $50. Inaddition, she did not pay her copay for the root canal she mentioned on 8/20/13(in the [redacted] office) which totaled $50. This left her with an initialbalance from both procedures of $167.She was sent statements from the [redacted] office on 8/27/13, 9/17/13, 10/7/13, 10/28/13 and 11/19/13.She was sent statements from the [redacted] office on 11/8/13, 12/20/13 and2/21/14. These bills were followed up by a phone call on 3/10/14 to her homenumber where a message was left. Then she was sent a collection letter on3/28/15 which detailed the two balances which included the previous $167 andfinance charges in the a[redacted] of $8.54. This letter stated,“We recently reviewed your financial status andwere surprised by your lack of response to our numerous attempts to collectfinal payment for treatment you received.According to our records, your remaining balance of $ 175.64 includes interest in the a[redacted] of$8.64 on charges accrued in our [redacted] and [redacted] Offices. Pleasecheck your records and contact us immediately if they do not match ours, so wecan correct any discrepancy.If your records agree with ours, we regard this as a very serious situation. We certainly do not wishto be forced to seek other recourse to collect the money owed. We want tocommunicate with you. If we do not hear from you within 10 days, we will turnyour account over to a collection agency. “We turned her account over to the [redacted], a ([redacted]) collection agency, on 5/23/14at which point our attempts to collect the debt were ceased. At that point, aswas clearly defined in the Patient Liability Agreement she signed on 8/20/13, a35% collection fee (as defined by the balance of the bill due divided by .65)was added to her current balance (as of that date $179.13) which brought herbalance to $275.58. She states that she “talked to the company” on 2/24/14 and 2/18/15. She has never contacted ouroffice regarding the multiple statements she has been sent, nor returned thephone call that was made to discuss the debt. The only interaction the officehad with Mrs. [redacted] since the collection letter was sent from our office wastwo days ago 2/23/15 when Mrs. [redacted] sent us a fax stating her complaint andthat if we did not resolve it by only making her pay $122.78 she would complainto the Revdex.com. We were still in the process of reviewing the information that wasreceived less than 24 hours before she made her complaint to you.The patient would like us to “eat the charges” for a procedure she agreed to have done and collectionfees that she agreed to in writing when she has never made an effort to resolvethis debt or dispute it with our office. We would be happy to discuss thesituation and the possibility of reducing the original debt but the collection fees were incurred due to thefact that she ignored our attempts to collect or resolve the debt and thecollection agency will not waive them.Sincerely,[redacted]Practice Manager[redacted]###-###-####