ComplaintsforJeffrey L. Wilden DDS, Inc.

• Initial Complaint

  02/02/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  September 26, 2022 I received a dental cleaning at *** ****** ****** The dentist told me I needed partials. I received x-rays and never received any other service for partials. I called once a month from October to January 2023 for an appointment to receive partials and I was told “my insurance couldn’t find my information”. On January 26, 23 I asked for my medical records and was told I would receive them by email in 3-5 business days. I have not received anything as of February 1, 2023.

  Business response

  02/09/2023

  To whom it may concern,

  The service that the patient wants, partial denture, requires a prior authorization with her insurance before we are allowed to start the process to make it.  We attempted to send the prior authorization to the patient's dental insurance.  The patient's dental insurance will not allow a prior authorization at this time stating that the patient's insurance program is switching to a different program.  Once the dental program changes to a different manage care plan then we can send the prior authorization to the new program. We have been waiting to find out by the patient what new program she is changing to so we can send the prior authorization.  Again, the insurance requires a prior authorization for this procedure in order to agree to payment, but the insurance will not accept the prior authorization until the patient's program switches to a manage care program.  The delay is not on our practice, but the delay is waiting for the patient's insurance program to switch over to a manage care program. This has been explained many times to the patient that we need the new program in order to send prior authorization.  We are more than happy to send the prior authorization once we receive the information from the patient. After speaking with the front desk staff, the patient never requested her records.  We are more than happy to send her records to her.  We require 10 business days, by law we have 30 days to send over.  Please have the patient contact our office to fill out a record release form so we can send her records to her. Thank you.

  Respectfully,

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

  The Dental Group

   

  Customer response

  02/10/2023

  I started this process in September of 2022. I called my insurance which was Medicaid as per the front desk in January 2023 after many attempts to get answers from The Dental Group. I was told by my provider that it doesn’t take 6 months to approve a prior authorization. My insurance company informed me that if I received service in September and a prior authorization was submitted it would only take about 30 days. There was no record with my insurance that a prior authorization was ever sent. I was also informed that my insurance was being switched February 1, 2023 which The Dental Group had knowledge of because the front office person provided me with that information as well. The front office person I spoke to was the office manager *********. I was also told when I asked for my records that they would be sent to me by email in 5 days. I also was never asked to fill out a medical release form.
  
  Regards,
  
  **** *******

  Customer response

  02/28/2023

  Good morning,
  I received an email stating this case was closed. Please consider my response as part of your determination. I was given a 10 day window to respond as to whether or not the business complied to my request for my medical records. The business did not send my records until after the BBB window of 10 days. However, a copy of the prior authorization was not given to me with the other records that were sent to me.
  Please take this into consideration and add it to my complaint, if it is going to be publicly posted.
  Sincerely,
  
  **** ******* 

• Initial Complaint

  12/02/2021

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  Sept 21st I went to *** ****** ***** *** ****** ********. After my x-ray it was suggested that I came back for periodontal Cleaning. On Oct 27th I returned and paid 350.00 (my portion) after insurance. I paid before service was rendered. I was led to the back and the hygienist looked at me and said that he would prefer that the dentist do the cleaning. They had no appointments in that office that I could make because I have a set work schedule. So they gave me appointment at the ************ office. I went home and read the reviews and the reviews were horrible. I called the office and canceled the appointment in ************ and asked for my refund. The secretary stated once the insurance pay for my x-ray bill they will refund my money back on my credit card. Which could take up to 30 days. I started calling about my 350.00 in Nov. 2021 and was getting the run around. They were telling me that they havent received any payment yet. I called Met Life to get an E.O.B. (Explanation of Benefits) mailed to me. I received it and went up to the Dental Group on Monday Nov.29th 2021. I asked to speak to someone in Billing. I waited at least 25 minutes and no one came to the lobby. This morning I called Metlife ref. # ********** I was told that the payment was mailed out on Sept. 24th and the check was cashed on Oct. 14th 2021 This morning, I called Metlife and they called the Dental Group while I was on the phone and they stated someone will call back. They have received payment and holding my money that I am paying interest on. I just need help retrieving my money I have also contacted the Ohio Attorney General's Office. Ref#******

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