Complaints

• Initial Complaint

  01/21/2025

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had oral surgery at Foundation Dental on 7/19/24. Weeks before the procedure, the coordinator **** presented the treatment plan, stating that the total cost was approximately $2,300. She explained that my insurance would cover 50%,and I would be responsible for 50%. I ok to this arrangement. A week before procedure,**** called again and asked me to pay in advance so that on the day of the procedure, I could simply go in, have the procedure done, and leave.I paid $1,170 over the phone.Last week,I received a bill from them stating that I owe $660 for the procedure.I called back and asked to speak to ****,to ask why and I reminded her that,prior to the procedure,she told me she had checked with my insurance and that $1,170 was my responsibility.I also said there were no additional services added during the procedure that could explain the extra charges.**** said that she didnt know why. She said that they had submitted the claim and that if the insurance company didnt cover the amount,I would have to pay it. When I asked why the insurance didnt cover the amount, she repeatedly said she didnt know and told me to call my insurance. On January 15, 2025, at 11:50 a.m., I called MetLife customer service at ************** and spoke to a lady named Vel on a recorded line. I asked her about the claim and the reason for the discrepancy in coverage. Vel informed me that Foundation had never contacted ******* to inquire about my insurance coverage for this ************ pre-authorization had been submitted, and there were no records in their system indicating that Foundation had called to confirm the coverage or cost.Vel explained that if Foundation had contacted *******, it would have been straightforward to provide the coverage details. I feel that Foundation failed to do their due diligence in checking with my insurance, and now they are forcing me to pay additional money.Had I known the actual cost would be closer to $1,800, I would not have proceeded with the procedure.

  Business response

  01/29/2025

  Dear Mr. **************** style="font-size: 0.875rem;">We have received your complaint, which was reported to the Better Business Bureau, and we want to express our sincere apologies for any frustration this situation may have caused. Patient satisfaction is incredibly important to us, and we take all concerns seriously.

  Upon thoroughly reviewing the matter, we found that you signed a treatment plan in 2023, which outlined the fees associated with each procedure. Additionally, we have documentation from ******* confirming your benefits. As an out-of-network provider, we make every effort to inform patients that the estimated insurance coverage is based on the insurance companys fee schedule, which is not always a guarantee. We also want to note that while we are happy to assist with insurance matters, pre-authorizations are only submitted upon a patients request.

  We understand that navigating insurance details can be complex, and were committed to improving our communication moving forward. If you would like to discuss this further or need assistance with understanding the charges or insurance coverage, please don't hesitate to contact us directly. We want to ensure you have a clear understanding of your treatment and fees at every step of the process.
  

  Thank you for bringing this to our attention, and we hope to resolve this to your satisfaction.

  Warm regards,

  Foundation Dental Specialists Management Team

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩