ComplaintsforHoward Family Dental

• Initial Complaint

  02/04/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I received an estimate on 5/17/2021 for 2 ******** in the amount of $2160. In Oct. of 2021 I began the process of having the fitting done for the ********. On the first visit I paid $2160. Second visit to have the ******** put in was the later part of Nov. I was not asked for additional payment as I exited the office. I received a balance due bill in the middle/later part of Dec. 2021 stated that I owed $3264 in addition to what I have already paid. I have made several phone calls beginning in Dec./Jan....mostly I seem to get "*******" who does not handle insurance area. Always states that she will take my name & number & have the correct person return my call. Around Jan. 27th I had a message left on my voicemail around 4:30pm time frame from the manage stating that they had contacted the insurance company & the procedure I had done was not covered. So the office closes at 5:00 pm daily & they are closed all day on Friday. I tried again on Monday Jan. 31st & got ******* again.... same story... the correct party will call you back... its Thurs. Feb. 3rd and not a peep but they can send me a bill since I have received 2 more. Here are my questions that I have been unable to get a clear responses for: ** Why was my insurance company NOT called when I asked for the estimate? One answer I received was "we don't do that unless asked by the customer" Exactly HOW is this a good faith estimate of the out of pocket cost for the procedure if the insurance company is NOT called? ** How can I make an informed decision about my course of treatment if I do not receive a clear estimate for cost of service? If I had know in advance that this procedure would cost me +$5000 out of pocket I would have investigated other dental practices for this procedure. I feel I have been lead in with one quote for service and now they find out insurance will not pay ( why did they not check when the estimate was requested?) and they are pinning the cost on me...sounds like a bait & switch.

  Business response

  03/01/2022

  See Attached.

  Customer response

  03/02/2022

    From: * ******* <********************>

  Sent: Wednesday, March 2, 2022 4:01 PM
  To: ****** ****** <********************>
  Subject: BBB Complaint #********

   

  Thank you for the information the Howard Dentals response. 

   

  My main grievance is the estimate. WHY was the insurance company not contacted to give the best possible estimate?? Calling the insurance company when as estimate is requested should be standard practice so the client will have a realistic quote for the procedure. IF I had received a quote stating that my out of pocket expense for this procedure would be over $5000 I would have investigated other dental practices before proceeding. So instead I make two more trips through the office thinking everything is fine…pay $2100on the first visit  to begin the work. Then a bill floats in during Dec. for an additional $3200 over & above what I have all ready paid. The explanation given was the insurance did not discount/pay as much as expected. I needed to know that BEFORE I started not after the work was completed. So why wasn’t the insurance called before any work began?

  **** ******* 

  
  
  

  Business response

  03/08/2022

  See Attached.

  Business response

  03/08/2022

  03/08/2022 ID# ******** To Whom It Concerns; We understand and acknowledge the patients concerns. However, as in the previous response our office does not know the amount that an insurance company will pay and/or any discounts that an insurance company might give until a claim has been submitted. You can submit a pre treatment estimate to insurance before any work has been performed. But pre treatment estimates will also state that it is an estimate only. Our office receives a breakdown of benefits from each patients insurance policy. Those breakdowns are put into our computer which is where the estimates are calculated. ***** does not pay towards ****** etc. until all of the work has been completed and the ****** have been seated. Therefore we are unsure of the exact patient portion until all claims have been submitted to *****. ***** tells us what the patient portion is and what they have paid towards claims. Again this is why our treatment plans state it is an estimate only. Any information given by ***** is considered an estimate until the work has been done and a claim has been submitted. ***** will also state this as well. Our office has a contract with ***** and it is our responsibility to collect the patient out of pocket portion that ***** determines. Sincerely, Howard Family Dental ********** **** ********* ***** **** *********** ** ***** 

  Customer response

  03/09/2022

   

  From: * ******* <********************>
  Sent: Wednesday, March 9, 2022 1:42 PM
  To: Info <*****************>
  Subject: complaint #********.

   

  Good Afternoon, 

  Please provide me a copy of the signed pretreatment review for this procedure. 

  Thank you. 

  **** *******

   

  Business response

  03/14/2022

  Attached is the patient's signed treatment plan per her request.
  

   

  --

   

  Howard Family Dental 

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

  **********, ** *****

  P: ************

  F: ************

  Customer response

  03/18/2022

  Good morning,

  I would just like to update you as to where I am at with this process.

   

  I have contacted my insurance company (they show no record of ever being in contact with the dentist concerning an estimate for this procedure) & they are going to file a complaint or contact with the dentist office concerning billing/estimation procedure.

   

  I have also contacted the ******* State Dental board & asked them to contact their office concerning this method of giving estimates. The case has been assigned an investigator & she has been in contact with me.

   

  I have not responded to the dentist office last submission because it’s seems we have reached an impasse.  I still content that I should have had a clear picture of out of what my  pocket expense would be for the procedure.

  According to their response,”You can submit a pre treatment estimate to insurance before any work has been performed. But pre treatment estimates will also state that it is an estimate only. Our office receives a breakdown of benefits from each patients insurance policy. Those breakdowns are put into our computer which is where the estimates are calculated. “ My insurance company never received a request for a “pretreatment plan.” I had no clue I needed to ask for one…really thought that was the purpose of requesting an estimate. Seems I did not know the correct terminology. I did not understand why I needed to ask them to contact the insurance company….other medical offices ( businesses in general) contact insurance as a matter of course so the client will have a clear picture of what out of pocket expense they will have to come up….all well before any work begins.

   

  Do you have any other suggestions? Am I out of line in my thinking about this situation? I am continuing to be billed for this procedure & I am not wanting this to have a negative impact on credit rating.

   

   

  ****

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