Western New York Dental Group

I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution is satisfactory to me Regards, [redacted] - [redacted]

The consumer called to say the complaint was resolved and she received copy of invoice with zero balance

I spoke with [redacted] on 2-28- I let her know that everything was submitted but wanted to know how I could rectify the situation I told her I would speak to my staff about the treatment she received I apologized and let her know that she should contact me directly if any problems should occurThank you, Susan [redacted]

The PM of our Western New York Henrietta office has been in direct contact with both the patient and the insurance companyA claim for services provided was paid out of network, which resulted in a contractual insurance adjustment being reversed by our national posting team and the patient being billed for additional dollars in errorA refund to the insurance company in the amount $is in process for the overpayment by [redacted] and the patient that she is paid in fullPlease let me know if you have any other questionsThank you Julia T***Operations, DirectorWestern New York Dental Group

I am writing in response to your letter received on January 18th, ID Our office contacted [redacted] - [redacted] concerning her complaint She had requested that both Rebecca and Jackie call her to apologize This has been resolved and both of these girls have spoken to her and did apologize If there is anything else you need from me please don’t hesitate to contact meThank you Denise [redacted] Practice Team Lead Western New York Dental Group

Patient returned my call this morningI apologized for the inconvenience we have caused him and informed him we would do what is necessary to resolve this for himPatient did not want money on a credit card, but wanted cash since that is how he paidInformed the patient that I would have it ready
for him whenever he would like to come by and pick it upPatient thanked me, and I expressed again how sorry I was and that we value him as a patientPatient came down and picked up his $in cashPatient left happy and will reconsider returning here as a patient

l received a notice from your office regarding a customer complaint submitted against WNYDG for denial of patient care and accusations*** *** did contact our Orchard Park location of WNYDG on May 31, to make an appointmentThe patient service representative brought up her patient record at which time she did notice that the patient was dismissed from our practice while she was a patient at our Hamburg locationFollowing protocol she advised *** that we are no longer able to treat her as she was dismissed as a patient and that perhaps she should seek dental care through another providerIt is noted that *** rebuffed the claim that she was ever sent a dismissal letter and that she was dismissed due to her behaviorl have attached a letter that was sent to *** on October 4, dismissing her from WNYDG but providing emergency care for days from the date of the letterThis letter was mailed and then scanned into our electronic records on October 4, We also have conversations documented from February 15, 2013; September 18, and finally October 4, that led to the decision by our Partner and Associate Doctor as well as our Operations Manager and Practice Manager to dismiss her due to her inappropriate behavior in speaking with our staffDismissing a patient is not something that our company takes lightly; in this case it was the only option due to escalating verbally abusive encounters. Note that since the time of this dismissal shehas not contacted any of our WNYDG offices for treatment until May 31,2016, two and one half years laterIn addition, since the time of her dismissal her family has continued to be treated at our offices. In conclusion we maintain our stance in her dismissal and feel that it is both of our best interest for her to seek dental care from another providerRegarding her request to modify and discontinue the adverse claim of accusations: the encounters were documented in the patient's electronic record, which are not amenable and are held as private record only viewable by staff members when accessing her patient recordIf you have any questions or need additional information please contact me at 716-677-Thank you for your assistance with this matterI greatly appreciate your timeSincerely, Michelle R*** Practice Manager Westem New York Dental Group

Hello ***, We have received the complaint for *** ***. I spoke with *** and received the correct insurance information. Services were resubmitted to insurance. I apologized and patient was satisfied. If you need any other information please let me know.
Thanks, Sue Susan *** Practice Team Lead

To Whom lt May Concern: l received a notice from your office regarding a customer complaint submitted against WNYDG for denial of patient care and accusations*** *** did contact our Orchard Park location of WNYDG on May 31, to make an appointmentThe patient service
representative brought up her patient record at which time she did notice that the patient was dismissed from our practice while she was a patient at our Hamburg locationFollowing protocol she advised *** that we are no longer able to treat her as she was dismissed as a patient and that perhaps she should seek dental care through another providerIt is noted that *** rebuffed the claim that she was ever sent a dismissal letter and that she was dismissed due to her behaviorl have attached a letter that was sent to *** on October 4, dismissing her from WNYDG but providingemergency care for days from the date of the letterThis letter was mailed and then scanned into our electronic records on October 4, We also have conversations documented from February 15, 2013; September 18, and finally October 4, that led to the decision by our Partner and Associate Doctor as well as our Operations Manager and Practice Manager to dismiss her due to her inappropriate behavior in speaking with our staffDismissing a patient is not something that our company takes lightly; in this case it was the only option due to escalating verbally abusive encounters. Note that since the time of this dismissal shehas not contacted any of our WNYDG offices for treatment until May 31, 2016, two and one half years laterIn addition, since the time of her dismissal her family has continued to be treated at our officesIn conclusion we maintain our stance in her dismissal and feel that it is both of our best interest for her to seek dental care from another providerRegarding her request to modify and discontinue the adverse claim of accusations: the encounters were documented in the patient's electronic record, which are not amenable and are held as private record only viewable by staff members when accessing her patient recordIf you have any questions or need additional information please contact me at 716-677-Thank you for your assistance with this matterI greatly appreciate your timeSincerely, Michelle R*** Practice Manager Westem New York Dental Group

I have reviewed the response
made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below. This response does not acknowledge Western NY Dentals reporting of my 'delinquent account' to the credit bureaus. I would like that matter addressed and all adverse affects to my credit score, because of it, resolved. Regards, *** ***

The consumer called to say the complaint was resolved and she received copy of invoice with zero balance.

Our team member spoke to the patient on Monday February 26, 2018.  She advised the patient that the insurance had processed the claim and payment was on its way to us.  Payment did come in today from [redacted]. Patient was made aware .  Thank you

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.  Regards,  [redacted]

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below. I have no idea what the dental office means by "no fault" and was never asked to furnish any such number. What I told them from the outset was that I did not have dental coverage on my insurance policy with Independent Health; however, since the injury was caused by a fall from a ladder, i.e., an accident, the insurer will pay for treatment, less any co-pay.  Regards,  [redacted]

I am writing in response to your letter received on January 18th, ID 11861083.  Our office contacted [redacted]-[redacted] concerning her complaint.  She had requested that both Rebecca and Jackie call her to apologize.  This has been resolved and both of these girls  have spoken...

to her and did apologize.  If there is anything else you need from me please don’t hesitate to contact me. Thank you Denise [redacted] Practice Team Lead Western New York Dental Group

I spoke with [redacted] on 2-28-2017.  I let her know that everything was submitted but wanted to know how I could rectify the situation.  I told her I would speak to my staff about the treatment she received.  I apologized and let her know that she should contact me directly if any problems should occur. Thank you,  Susan [redacted]

I am writing to you in response to the above mentioned complaint from [redacted] which was received on January 19, 2016. Mr. [redacted] presented to our office on March 21, 2015 with a broken tooth which he stated was a result of falling off a ladder. The patient did not state that this was going...

through his medical insurance as a no fault claim and so no claim was sent until Mr. [redacted] follow up appointment on May 18, 2015 when he was informed that there was still an unpaid balance. On May 18, 2015 Western New York Dental Group filed a claim to Independent Health for both March 21, 2015 and May 18, 2015 dates of service, I requested the no fault claim number from the patient, as we normally do for these cases, he did not have this number for me. Mr. [redacted] returned for a no charge follow up visit on July 20, 2015 at which visit we still did not receive payment for any claims submitted. As a result I called Independent Health on July 22, 2015 and spoke to [redacted] who told me that she saw all of the information necessary to process the claim and was unsure as to why it had not paid yet. [redacted] advised me that she would send the claim back for follow up and reprocessing. Mr. [redacted] was again seen on September 15, 2015 and a claim was submitted on a CM-1500 claim form on September 16, 2015. Mr. [redacted] was then seen on October 5, 2015 for a post and core, this claim was submitted on October 26, 2015 as the claim never generated in our system. Along with this claim follow up was also made on the previously mentioned three (3) claims that still were not paid on. I again made a follow up call to Independent Health on November 30, 2015 for the above four (4) claims and spoke to Robin who told me that she would reprocess the claims as she also saw all of the necessary information on the claims received except for the claim on October 5, 2015 which I needed to send an updated ICD-10 code on and did so the same day. I received a letter from Independent Health on January 13, 2016 for the claim dated October 5, 2015 again requesting the new ICD-10 code which was again sent. On January 18, 2016 I called Independent Health in response to a fax that we had received regarding a complaint that Mr. [redacted] sent to them. I spoke to [redacted] and faxed the information that she was requesting, including but not limited to previously submitted claims, treatment notes, and a narrative. I am continuing to work with the representatives at Independent Health to get these claims processed. Our computer software automatically sends out statements to our patients after 90 days of an unpaid balance where it is the patient or the insurances responsibility in order to keep the patients informed of what is going on with their account. We have in no way denied Mr. [redacted]’ treatment or made him pay for the above mentioned services, when Mr. [redacted] has questioned the office about the automatically generated statements we assure him that we are still waiting for payment from his insurance and that he does not have to pay. Sincerely, [redacted], Practice Manager

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint.  Sue is trying to make it seem as though I was at fault by not initially providing the correct insurance information.  Also, she is claiming that she "resubmitted" a claim.  There was only one claim submitted in the four months since my son was seen at her office.  I have proof of this.  She never apologized for the incompetence and rude behavior of her staff.  When they finally decided to submit a claim in February for services that were received in October, she had to ask me for all of the information that I had already provided at the time of the visit.  How did they submit a claim previously without any of this information?  They didn't.  Now they are trying to make it appear as though I am at fault.  They absolutely did not apologize and they intentionally did not submit a claim.  I would like an apology for the ordeal that I have been put through for the past four months of begging them to submit a claim and being given the run around.   Regards,  [redacted]

[redacted] called and stated, in response to the consumer's rebuttal: No fault means" the injury was caused by a fall or an accident", nobody was at fault, which you should have filed the claim with Independent Health first, and obtained the "no fault id number".  If all would have been processed with the "no fault id number", the process would have been quicker. It is now in the hands of Independent Health to confirm all claims currently in process. If you have any further questions, please contact us or Independent Health with your no fault claim number for an update.

The PM of our Western New York Henrietta office has been in direct contact with both the patient and the insurance company. A claim for services provided was paid out of network, which resulted in a contractual insurance adjustment being reversed by our national posting team and...

the patient being billed for additional dollars in error. A refund to the insurance company in the amount $346.50 is in process for the overpayment by [redacted] and the patient that she is paid in full. Please let me know if you have any other questions. Thank you Julia T[redacted]Operations, DirectorWestern New York Dental Group