Theodore E Dando DMD

October 5,2017This letter is in response to the complaint which you received from our patient with regard to the "scam" for services rendered.The aforementioned patient was initially seen in our office on 2/21/for the services in questionAs is our office policy with every patient, the patient was notified of his financial from the outset of their relationship with our officeEach patient is given the office "Financial Policy" and requested to review and acknowledge with his/her signatureThis, in fact, was given to and acknowledged by the patient as retained in our records.As the financial policy states, as a COURTESY, to our patients, we will submit and attempt to retrieve accurate insurance information for them, however, it is ultimately the patient's responsibility to both know and contact their insurance company, if necessary, to ensure coverage for services being renderedThis follows standard office policy for nearly every type of provider of services in the country.As I have attached, a good faith effort was made to retrieve coverage information for the patient the day of service on his behave, per his requestWhen notified that we believed there would be 50% coverage per the eligibility information we received from the insurance company's website, he inquired as to what "todays visit would cost him"We ESTIMATED it would be approximately $He replied by stating he was not prepared to pay the expense that dayWe agreed to allow payment at the final appointment for his estimated portion.After submitted the necessary information to process his claim, the insurance company denied ALL coverage on the responding Explanation of Benefits, which the patient also received directly from his insurance companyAn attempt was made at that time to contact the patient to encourage him to call his insurance carrier to inquire as to why they denied coverage, we received no responseAfter a second submission on our part, it was denied again.Shortly thereafter, we received a voicemail message from the patient stating "I am not paying anymore, stop sending me bills"I personally took the time to call the patient's insurance company to identify exactly why it was a non-covered serviceIt took both the customer service rep and myself over minutes to discern policy underwriting to identify how the policy was written and why the claim was denied to which the CSR stated "I have NEVER seen a policy written like this before, but I see we have received no inquiries from the insured with regard to this matter"After speaking with his insurance company, I attempted to contact the patient again to both detail my recent conversation/findings with his insurance and resolve the issueAgain, I received no response.We, as we do for all of our patients, attempt to make every effort to maximize their insurance benefits within the guidelines of the policyHowever, it is ultimately the patient's responsibility to know and understand their coverage.None the less, services were rendered to him and therefore is responsible for the entire billed amount regardless of the contract between he and his insurance companyWe strongly believe, that we have already gone above and beyond, by both seeking further information regarding his insurance and their denial, as well as, the courtesy adjustment that had already been made in May as a good faith offering.It is not the policy of this practice to deceive or mishandle our patients in any wayHowever presented, this patient's account of the incident in question is both inaccurate and unfair to our business as we have made every effort to work on his behalf AND contact him despite the fact that he has made NO attempt of his own.I therefore, request you dismiss this claim as I have clearly offered you both verbal and written documentation to substantiate both patient responsibility as well as the effort made to remedy the situation with this patient regardless of the fact that it was not our legal or financial obligation to do soDespite our financial loss for the services already rendered him, we chose to adjust the account to a zero balance, though not our obligation.Every single patient is important to usWe do the best we can for each and every one of our patients, each and every time they visit our officeWe do understand that, at times, there may be confusion, even frustration, simply because we handle financial transactions which is a deeply personal matter to all of us.Thank you for your time and effort in discerning this matter.Sincerely,Jill J.Office Manager

October 5,2017This letter is in response to the complaint which you received from our patient with regard to the "scam" for services rendered.The aforementioned patient was initially seen in our office on 2/21/for the services in questionAs is our office policy with every patient, the patient
was notified of his financial from the outset of their relationship with our officeEach patient is given the office "Financial Policy" and requested to review and acknowledge with his/her signatureThis, in fact, was given to and acknowledged by the patient as retained in our records.As the financial policy states, as a COURTESY, to our patients, we will submit and attempt to retrieve accurate insurance information for them, however, it is ultimately the patient's responsibility to both know and contact their insurance company, if necessary, to ensure coverage for services being renderedThis follows standard office policy for nearly every type of provider of services in the country.As I have attached, a good faith effort was made to retrieve coverage information for the patient the day of service on his behave, per his requestWhen notified that we believed there would be 50% coverage per the eligibility information we received from the insurance company's website, he inquired as to what "todays visit would cost him"We ESTIMATED it would be approximately $He replied by stating he was not prepared to pay the expense that dayWe agreed to allow payment at the final appointment for his estimated portion.After submitted the necessary information to process his claim, the insurance company denied ALL coverage on the responding Explanation of Benefits, which the patient also received directly from his insurance companyAn attempt was made at that time to contact the patient to encourage him to call his insurance carrier to inquire as to why they denied coverage, we received no responseAfter a second submission on our part, it was denied again.Shortly thereafter, we received a voicemail message from the patient stating "I am not paying anymore, stop sending me bills"I personally took the time to call the patient's insurance company to identify exactly why it was a non-covered serviceIt took both the customer service rep and myself over minutes to discern policy underwriting to identify how the policy was written and why the claim was denied to which the CSR stated "I have NEVER seen a policy written like this before, but I see we have received no inquiries from the insured with regard to this matter"After speaking with his insurance company, I attempted to contact the patient again to both detail my recent conversation/findings with his insurance and resolve the issueAgain, I received no response.We, as we do for all of our patients, attempt to make every effort to maximize their insurance benefits within the guidelines of the policyHowever, it is ultimately the patient's responsibility to know and understand their coverage.None the less, services were rendered to him and therefore is responsible for the entire billed amount regardless of the contract between he and his insurance companyWe strongly believe, that we have already gone above and beyond, by both seeking further information regarding his insurance and their denial, as well as, the courtesy adjustment that had already been made in May as a good faith offering.It is not the policy of this practice to deceive or mishandle our patients in any wayHowever presented, this patient's account of the incident in question is both inaccurate and unfair to our business as we have made every effort to work on his behalf AND contact him despite the fact that he has made NO attempt of his own.I therefore, request you dismiss this claim as I have clearly offered you both verbal and written documentation to substantiate both patient responsibility as well as the effort made to remedy the situation with this patient regardless of the fact that it was not our legal or financial obligation to do soDespite our financial loss for the services already rendered him, we chose to adjust the account to a zero balance, though not our obligation.Every single patient is important to usWe do the best we can for each and every one of our patients, each and every time they visit our officeWe do understand that, at times, there may be confusion, even frustration, simply because we handle financial transactions which is a deeply personal matter to all of us.Thank you for your time and effort in discerning this matter.Sincerely,Jill J.Office Manager

October 5,2017This letter is in response to the complaint which you received from our patient with regard to the "scam" for services rendered.The aforementioned patient was initially seen in our office on 2/21/17 for the services in question. As is our office policy with every patient, the patient...

was notified of his financial from the outset of their relationship with our office. Each patient is given the office "Financial Policy" and requested to review and acknowledge with his/her signature. This, in fact, was given to and acknowledged by the patient as retained in our records.As the financial policy states, as a COURTESY, to our patients, we will submit and attempt to retrieve accurate insurance information for them, however, it is ultimately the patient's responsibility to both know and contact their insurance company, if necessary, to ensure coverage for services being rendered. This follows standard office policy for nearly every type of provider of services in the country.As I have attached, a good faith effort was made to retrieve coverage information for the patient the day of service on his behave, per his request. When notified that we believed there would be 50% coverage per the eligibility information we received from the insurance company's website, he inquired as to what "todays visit would cost him". We ESTIMATED it would be approximately $357.32. He replied by stating he was not prepared to pay the expense that day. We agreed to allow payment at the final appointment for his estimated portion.After submitted the necessary information to process his claim, the insurance company denied ALL coverage on the responding Explanation of Benefits, which the patient also received directly from his insurance company. An attempt was made at that time to contact the patient to encourage him to call his insurance carrier to inquire as to why they denied coverage, we received no response. After a second submission on our part, it was denied again.Shortly thereafter, we received a voicemail message from the patient stating "I am not paying anymore, stop sending me bills". I personally took the time to call the patient's insurance company to identify exactly why it was a non-covered service. It took both the customer service rep and myself over 45 minutes to discern policy underwriting to identify how the policy was written and why the claim was denied to which the CSR stated "I have NEVER seen a policy written like this before, but I see we have received no inquiries from the insured with regard to this matter". After speaking with his insurance company, I attempted to contact the patient again to both detail my recent conversation/findings with his insurance and resolve the issue. Again, I received no response.We, as we do for all of our patients, attempt to make every effort to maximize their insurance benefits within the guidelines of the policy. However, it is ultimately the patient's responsibility to know and understand their coverage.None the less, services were rendered to him and therefore is responsible for the entire billed amount regardless of the contract between he and his insurance company. We strongly believe, that we have already gone above and beyond, by both seeking further information regarding his insurance and their denial, as well as, the courtesy adjustment that had already been made in May as a good faith offering.It is not the policy of this practice to deceive or mishandle our patients in any way. However presented, this patient's account of the incident in question is both inaccurate and unfair to our business as we have made every effort to work on his behalf AND contact him despite the fact that he has made NO attempt of his own.I therefore, request you dismiss this claim as I have clearly offered you both verbal and written documentation to substantiate both patient responsibility as well as the effort made to remedy the situation with this patient regardless of the fact that it was not our legal or financial obligation to do so. Despite our financial loss for the services already rendered him, we chose to adjust the account to a zero balance, though not our obligation.Every single patient is important to us. We do the best we can for each and every one of our patients, each and every time they visit our office. We do understand that, at times, there may be confusion, even frustration, simply because we handle financial transactions which is a deeply personal matter to all of us.Thank you for your time and effort in discerning this matter.Sincerely,Jill J.Office Manager