Business ProfileforComfort Dental

On 3/8/23 I reached out to Comfort Dental-Grove City to schedule dental appointments for myself and my daughter. Prior to scheduling the appointments, I made sure that one of the dentists, Dr. ****** ****** was in network with each of my insurance plans: ****** ******* ******** ********** ******************** and ******** by entering the provider information on the insurance websites.

90% of my correspondence with Comfort Dental was via text messaging and I did retain these messages. With the understanding that I was scheduling with Dr. *****, I set up the appointments. I texted photographs of each of my insurance cards to the dental office on March 8th.

Weeks later, during the cleanings appointment, the dentist told me that I had tooth decay requiring crowns. He said that after reviewing my insurances, I was covered and my out of pocket expenses should be minimal. I took that as verification that my all of my insurances were accepted and I scheduled the appointment for additional work on April 26, 2023. I was told that I would have temporary crowns for a few weeks until my permanent crowns were made.

On April 28, 2023, after my appointments, I received an Explanation of Benefits from Humana that the claims submitted for our initial appointments were denied because the dentist was out of network. I thought the claims were submitted under the incorrect dentist, Dr. ******* ******* and reached back out to Comfort Dental. The Comfort Dental office manager, Jaime, told me that Dr. ****** did complete my exams but he is in network with my insurance and not to worry. I was concerned because Dr. ****** is not who I scheduled with.

Still waiting for my permanent crowns and after several months of back and forth, the office manager Jaime said that she misunderstood when calling to verify insurance. She thought my insurance was PPO instead it is an EPO network. I would be responsible for $971.60 before I can get my permanent crowns since Dr. ****** is not in network and that no dentist in their office is in my network.

Dr. *****, the dentist that I scheduled with is in network with my insurance. I did sign a financial agreement but that was based on the office submitting the claims properly and scheduling me with the dentist I requested. I even tried to see if they would accept fault and even if I did have to pay a discounted amount I would have.

I have done everything required of the dental/medical consumer. I used my insurance company's resources to find an in network provider. I attempted to make an appointment with that provider, but was scheduled with someone else. As soon as I became aware of the error, which was not my own, I made repeated phone calls to the dentist's office and my insurance company to resolve the misunderstanding between the insurance company and my provider.

The dentist's office maintains that they are not in network, while my insurance company clearly states that the provider I requested is in network.

While I would be perfectly willing to pay my portion under normal circumstances, I fail to see why I should be held responsible for what is in essence a bait and switch.