Complaints

• Initial Complaint

  01/03/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  The Mountain Oak Dental Clinic was responsible for contacting ********************** insurance company and NIHB and coordinate payment from both my insurance providers. They received documentation from NIHB indicating the amount they were willing to pay and then they were to forward that information on to ******** Group for the remainder. They never sent in the documentation and the insurance company did not pay any of the remaining bill. In June of 2023 I received and email stating that I would be responsible for paying the outstanding amount. When I went into the clinic they said they were having difficulty getting either group to pay but that they would resubmit the invoices to the insurance companies. I said I would inquire as to the problem and let them know that ******** Group pays for the first 10% and then waits to hear what NIHB will pay. I did not hear back from the dentist's office until I got a letter in the mail saying I still owed them money. This is 9 months later. I no longer have insurance through ******** Group as of November of 2023 or access to my health spending account of $500.00. When I contacted ****** in their office , through email, she informed me that it was really up to me to coordinate payments and that I should have asked them for the documentation sent to their office from NIHB. I contacted ******** Group and spoke to their representatives who told me that Mountain Oak Dental had NOT submitted the information from NIHB and that was the reason they had not paid the dental bill. I believe their accounting departments negligence in sending the documentation and the delay of 9 months in sending me the bill is incompetence and is directly responsible for my not having the cost of dental work paid for by my health insurance. Because of these factors I do not believe I should be responsible for paying for work that should have been covered by insurance.

  Business response

  08/03/2024

  Please see the attached response. Thank you! 

  Customer response

  14/03/2024

   
  Complaint: 21371499
  
  I am rejecting this response because:I read your response and again you take no ownership for the financial difficulties your office has placed me in due to your accounting practices. 
  Your office did not submit the response from Indian Affairs Health to ******** ********************* did not send a bill in a timely manner. 9 months
  I spoke to 5 different Dental offices in ******* and asked how they go about dealing with private insurance and they were very kind and forthcoming with the information they shared with me. They said they bill the private insurance first and whatever was still owed was then sent to Indian Affairs for payment. They said they had never had any difficulties getting paid. I also phoned Legacy Dental in ********** ( my previous dentist) and they told me the same thing. 
  All dental offices said they would never let an account go past 90 days without billing. One office suggested that the delay was because you did not notice the outstanding amount until your year end audit. 
  All dental offices said they take care of these matters for their clients and no one suggested it should be the patients problem to understand the billing process of their companies. 
  I am waiting for a SINCERE apology and ownership for your part in the situation AND waiving any amount owing after the insurance companies have paid their portions.
  Sincerely,
  *****************************
  
  
  
  
  Sincerely,
  
  B. *****************************

  Business response

  15/03/2024

  Please see the attached document as our final response. Thank you! 

  Customer response

  22/03/2024

  Better Business Bureau, I have sent 3 letters to Mountain Oak dental and each time they come back with the same response. It is obvious they will take no ownership for their inept business practices. I have researched billing practices of other dental clinics in the same area and found they did not follow common. procedures. It will not matter how many letters I send them they are not going to acknowledge their incompetence. Is there anything your organization can do? 

  Thanks 

  *****************************

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