ComplaintsforDr. Stephen Klein, DDS.

• Initial Complaint

  12/29/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Dr. ******************** ******************** was dishonest with us in regards to the required co-pays. My work switched insurances years ago and at that time we were informed that Dr. ******************** was not in the insurance network and that we would have to pay additional fees to continue to see him. We discussed this with the doctor at that time and he stated that he didn't want to lose us as customers so he would waive the fees. We continued to be seen by Dr. ******************** for years and I have no complaint with the quality of his work. This year he informed us that he was retiring and now is telling us that he has found that we owe him $708.60 in unpaid copays. He now says that he never told us that we didn't owe the out of network charges, but can not give me a reason why he never mentioned this "owed money" until he retired. Now he is threatening to take me to court if I do not pay him this large unexpected sum.I do not believe that I owe him any money, and I think Dr. ******************** has failed to uphold the *** code of ethics in Integrity, justice, professionalism, and veracity.

  Business response

  01/04/2024

  As specified in the ********** Practice Act, Article 12, section 810, I am obligated to follow the contractual guidelines with the insurance companies i work with.  It is the responsibility of the ******* to know the provisions of of their former dental insurance contract Guardian.  This contract stipulates that each patient must pay $50 dollars per person per year for each deductible.  Upon auditing my charts, I realized this had not been done consistently.  As I did not want to knowingly violate the Dental Practice Act or the working contract with Guardian, I personally went over the situation with your wife who assured me that "my husband would take care of it".  ************** you knew about this matter and yet I received no response from you for four months.  

  You allege in your complaint with the Better Business Bureau, that I agreed to waive the deductible for your family.  That is a lie; I would never knowingly break the law.

  Expecting or pressuring a dental office to violate the law is unethical and unacceptable.  In fact, waiving the insurance deductible or co-payments constitutes insurance fraud in the ******************* and could result in the suspension or revocation of a dentist's dental license.

  I worked very hard to give the best possible care to all my patients over the forty years I have held my dental license.  I am disappointed with your complaint with the BBB to get me to refund money which was contractually owed to me and your obligation to pay me is  entirely within the law in our *******************.

  Sincerely,

  Dr. Stephen Klein

  Customer response

  01/05/2024

   I am rejecting this response because:
  
  Dr. ******************** states that he is obligated to charge us because of ********** (or maybe Dental) Practice Act Article 12, section 810. The Dental Practice Act Article 12, section 810 states in relation to insurance fraud that: It shall constitute unprofessional conduct and grounds for disciplinary action, including suspension or revocation of a license or certificate, for a health care professional to do any of the following in connection with their professional activities: (1) Knowingly present or cause to be presented any false or fraudulent claim for the payment of a loss under a contract of insurance. (2) Knowingly prepare, make, or subscribe any writing, with intent to present or use the same, or to allow it to be presented or used in support of any false or fraudulent claim.
  
  This does not state that he must follow a contract, only that he must not present false or fraudulent claims. Furthermore, his obligations to an insurance contract are not my responsibility. In 2019 the doctor advised us that his dentist office was not in network with our new insurance, and when faced with a large copay for each visit (at this time I dont know what Dr. ******************** is talking about when it comes to a $50 dollar per person per year for each deductible charge. Three patients per year at that rate never equals $708.60) we had considered having to find an in-network dentist. At that time Dr. ******************** advised us that he would not charge us the extra fee for being out of network; I assume this was to encourage us to stay with his business. Since we were generally happy with his work we decided to stay on and my wife and two children continued to be seen by Dr. ******************** until he retired in April of 2023. 
  
  
  Dr. ******************** alleges that I and my wife are lying about him waiving the fee and yet, he continued to see us for years with this alleged unpaid growing balance without any mention to us despite multiple cash payments by us during the intervening period. It was only after he had retired that he mentioned there was an unpaid balance resulting from uncollected deductibles, unpaid insurance claims from 2020, and a smattering of small copayments. When I asked for a more itemized listing of these unpaid balances I did not hear back from Dr. ******************** until December 26th with a letter dated December 21st containing the requested invoice, and a threatening letter stating that I had until the 26th of December to respond or else he would begin legal proceedings. While he had finally provided me with the requested documentation, and I subsequently paid the requested amount to stop Dr. ******************** from taking legal action against me, I am still confused by the lack of co-pay or deductible listings on the invoice and if the doctor clearly had knowledge that we owed this money all these years, why would he suddenly discover this as he leaving the state?
  
  The documentation I received does not show co-pays *********** procedures charged and payments made. There are several credit card payments in 2020, 2021, and 2022 including the  $1500 payment you made her pay after she was in the dental chair and you had already numbed her mouth for the procedure. We were regular patients at your office, and there was ample opportunity to clear any unpaid balances, so why is this being leveed on us now?
  
  If it is a violation of the law for Dr. ******************** to waive debts because of verbal agreements he made to maintain his customers, then perhaps I inadvertently uncovered bad behavior on his part. On the other hand, it is unethical and unacceptable to go back on your word, and to shoulder your customers with your poor business choices. While the amount is deminimus compared to the cost of a legal challenge, it is not insignificant my family. Whether you were in error to waive the fee, had simply forgotten, or were unable to properly maintain your ledger, the ethical move would be to refund this money, and for both of us to use more caution when entering into business arrangements in the future.
  

  Customer response

  01/05/2024

   I am rejecting this response because:
  
  Dr. ******************** states that he is obligated to charge us because of ********** (or maybe Dental) Practice Act Article 12, section 810. The Dental Practice Act Article 12, section 810 states in relation to insurance fraud that: It shall constitute unprofessional conduct and grounds for disciplinary action, including suspension or revocation of a license or certificate, for a health care professional to do any of the following in connection with their professional activities: (1) Knowingly present or cause to be presented any false or fraudulent claim for the payment of a loss under a contract of insurance. (2) Knowingly prepare, make, or subscribe any writing, with intent to present or use the same, or to allow it to be presented or used in support of any false or fraudulent claim.
  
  This does not state that he must follow a contract, only that he must not present false or fraudulent claims. Furthermore, his obligations to an insurance contract are not my responsibility. In 2019 the doctor advised us that his dentist office was not in network with our new insurance, and when faced with a large copay for each visit (at this time I dont know what Dr. ******************** is talking about when it comes to a $50 dollar per person per year for each deductible charge. Three patients per year at that rate never equals $708.60) we had considered having to find an in-network dentist. At that time Dr. ******************** advised us that he would not charge us the extra fee for being out of network; I assume this was to encourage us to stay with his business. Since we were generally happy with his work we decided to stay on and my wife and two children continued to be seen by Dr. ******************** until he retired in April of 2023. 
  
  
  Dr. ******************** alleges that I and my wife are lying about him waiving the fee and yet, he continued to see us for years with this alleged unpaid growing balance without any mention to us despite multiple cash payments by us during the intervening period. It was only after he had retired that he mentioned there was an unpaid balance resulting from uncollected deductibles, unpaid insurance claims from 2020, and a smattering of small copayments. When I asked for a more itemized listing of these unpaid balances I did not hear back from Dr. ******************** until December 26th with a letter dated December 21st containing the requested invoice, and a threatening letter stating that I had until the 26th of December to respond or else he would begin legal proceedings. While he had finally provided me with the requested documentation, and I subsequently paid the requested amount to stop Dr. ******************** from taking legal action against me, I am still confused by the lack of co-pay or deductible listings on the invoice and if the doctor clearly had knowledge that we owed this money all these years, why would he suddenly discover this as he leaving the state?
  
  The documentation I received does not show co-pays *********** procedures charged and payments made. There are several credit card payments in 2020, 2021, and 2022 including the  $1500 payment you made her pay after she was in the dental chair and you had already numbed her mouth for the procedure. We were regular patients at your office, and there was ample opportunity to clear any unpaid balances, so why is this being leveed on us now?
  
  If it is a violation of the law for Dr. ******************** to waive debts because of verbal agreements he made to maintain his customers, then perhaps I inadvertently uncovered bad behavior on his part. On the other hand, it is unethical and unacceptable to go back on your word, and to shoulder your customers with your poor business choices. While the amount is deminimus compared to the cost of a legal challenge, it is not insignificant my family. Whether you were in error to waive the fee, had simply forgotten, or were unable to properly maintain your ledger, the ethical move would be to refund this money, and for both of us to use more caution when entering into business arrangements in the future.
  

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