Complaints

• Initial Complaint

  01/25/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I made an appointment to do regular cleaning on Jan 4, 2023. I have not been told that this is not regular cleaning and would be out-of-pocket treatment for the insurance. I got a surprise bill 15 days later that tell me the cleaning needed to pay by myself. They didn't give me a chance to choose whether I still would like to do regular cleaning or do the out-of-pocket treatment as they did not discuss that with me. In addition, I may be overtreated by that out-of-pocket treatment.

  Business response

  02/27/2023

  We are sorry to hear that the patient was not satisfied with the coverage of her insurance. Due to privacy concerns and laws we are not able to discuss the treatment needed and rendered.  I can however say that our hygienist had a full discussion with the patient as to what was needed in her particular situation and at no time did the patient ask to postpone treatment and obtain a predetermination to determine definitive coverage.  The insurance company did pay part of the fees, we wrote off a significant portion of the fees, as agreed to by contract, and the remaining balance that is the patient's responsibility is minimal.  The patient was informed at the time of service as to what was needed and there is no possible way we can know all the specifics regarding every individuals insurance coverage.

  Customer response

  02/28/2023

  Complaint: ********
  
  I am rejecting this response because:

  I contacted the dentist office since Jan 2023, but I did not get response almost a month.
  
  I made an appointment for regular cleaning on Jan 4, 2023. During the service and after service, I did not have any notices that my treatment was not the cleaning I required for. I got a surprise bill 15 day after the service.
  I received many times of cleaning before, but why I did not realize this was not the regular cleaning as I had before, and also did not informed at the office?
  As the dental office rejected discussions of my case by no response of my questions, the only way I can understand what was going on is to search the dental code and compared it with my understand of the X-ray at the office.
  I think the treatment I received on Jan 04, 2023 is actual the preventive care.
  Problems are localized instead of generalized moderate to sever. The dentist should not claim my situations only based on how long of my last cleaning was but on my actual situations. Based on my understanding of the X-ray, I only noticed three teeth may need to take more care of. If only for those three teeth, did it reasonable to claim my case with the code *****? The bill charged of the code ***** is the price of my three teeth or my overall teeth? I did not received scores of my each tooth when I was in the office, which makes this case very controversial, even though the dentist may supplement this record for me now. But when there is a case dispute, does the supplementary record have credibility?
  The service was incomplete. I was told that the time was limited and those incomplete cleaning might be continued next time if I still go there for the cleaning. I thought this was a regular cleaning and maybe it is ok to finish that next time. But now I noticed that the ADA document shows that ***** is a full mouth procedure and should be completed in a single day. Therefore, I think ***** is not applicable for my case. At the same time, I am confused whether the ***** of the bill charges for complete treatment or this incomplete treatment. I asked for the X-ray to understand my case but never got response. I think I have the right to know the truth, and I should be told that the treatment I received was not the regular cleaning I required before, not the moment I received the bill.
  
  Sincerely,
  ****** ****

  Business response

  03/27/2023

  The patient had contacted her dental insurance and we sent a letter in response to all of that regarding the patients request. So we just received a letter from Delta Dental and the letter was reviewed and it said the services we provided were appropriate and provided within the  standard of care.

  Customer response

  03/28/2023

  Complaint: ********
  
  I am rejecting this response because:
  
  The dental office did not give answers to the questions I asked. Please refer to the questions in my last complain letter.
  
  Sincerely,
  
  ****** ****

*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. ↩