Complaints

• Initial Complaint

  06/11/2024

  Complaint Type:

  Order Issues

  Status:

  Unresolved

  More info

  Date of service: February 7th 2024 -I had dental service done at this location. On the day of the visit I was presented with the treatment plan and the estimate, I was assured that all the presented procedures are covered by my insurance, and my copayment will be a certain amount, and they assure me that no more payment I should encounter, I happily paid my copayment right there at end of my visit. -Later on, I got a bill from them , and when I tried to inquire about it, office claimed that my insurance didn't cover the procedure and that is why I got the bill sent to me. -so my frustration is that I was told the insurance been checked and all procedures are covered and all I should owe is my copayment, turned out it is not covered. Which made me realize that this business, intentionally, lie to it's customers by informing them that a certain procedure or treatment is covered under their insurance to make them accept such procedure, and later on , billing them with the excuse that insurance didn't pay, knowing already that it won't be covered under this insurance. This clear act of Fraud by knowingly lying and misleading patients/customers by informing them that a procedure is covered, when it's not accordingly to the insurance Policy.

  Business response

  08/01/2024

  ***The Business Has Responded***

  ***Please See Attachment***
  

  Customer response

  08/12/2024

   
  Complaint: 21813379
  
  I am rejecting this response because:

  Per business responce, Qutoing "" According to the patients insurance, the negotiated fee for the respective procedure code is $153.26. The estimated insurance coverage for this procedure was estimated at 50%, which would have been $76.63"" end of qoute. 

  now, that is not true, as I spoke to the insurnace company and they informed that they never informed the business of that code D4346 is covered,, as per insurance representative" this code is not covered, and when the business called Us , we informed them that, and business asked about different code and we informed them that this different code is covered but not the D4346"" ,, therefore business knew about that this code is not covered but still provided this service code.    Business or the BBB can feel free to contact ****************** and listen to the recorded conversation , as insurance agent informed me that THEY NEVER INFORMED THE BUSINESS THAT THIS CODE D4346 IS COVERED. IT IS UNCOVERED CODE AND INSURNACE WILL NOT COVER ANY PART OF IT.  business knowingly provided uncovered service while informing patient it is covered. 

   

   

   

   

  Sincerely,
  
  Bayan Bakir

*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. ↩