ComplaintsforStudio Dental by Alexander Ash, DDS

• Initial Complaint

  07/03/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I requested a 6 month cleaning, x-rays and consented to an additional fluoride treatment. My insurance coverage was verified prior to my appointment and following completion of the appointment. I was told both times everything was 100% covered and there would be no out of pocket cost to me. I then got a bill. I called the dental office and they said insurance denied coverage because I'd seen another dentist within 6 months, which was incorrect. I called my insurance and they verified my appointment was more than 6 month since my prior visit and that the reason for the out of pocket charge was that the dental office charged me for an additional, comprehensive exam that I was not informed of and did not consent to. The dental office continues to fraudulently state that insurance denied the claim because of me not waiting the 6 month period. This is false. They are knowingly giving me false information (fraud) to conceal the fact that they are charging me for a regular cleaning and exam and a comprehensive exam, which was not requested or consented to and I'm not sure I received anything comprehensive because everything that was done was in line with a routine exam. They are upcharging me for items I didn't request and I don't believe they were received. This is fraud.

  Business response

  07/15/2024

  To Whom it May ***************** are responding to this complaint to explain and prove we did not do anything fraudulent or upcharge  this patient. She presented to our office for the first time on May 21, 2024. It is standard of care and routine that we get a full medical, dental history, and perform and exams and get x-rays prior to treatment being done. This is standard of care and presented to all our patients. We have records of a full set of x-rays being done, peridontal probings, and a comprehensive exam. Again this was a first time appointment to our office and we received no prior dental records and we can't properly treat the patient and do any procedures without comprehensively collecting dental records on them. If it was not consented then it would be impossible to take a full set of x-rays, and have all her existing past fillings and restorations and clear her of any cavities and diagnose her periodontal status as we did without her knowing of this, and we explain to patients that we needs comprehensvie records on them in order to treat them. We believe in giving the best dental care to our patients. We submitted all her treatment to the insurance, they incurred a payment from the patient of $53 after we submitted and received her estimate of benefits. As routinely known, what the insurance pays out is an estimate from our end until the insurance replies back. The patient, as per the estimate of benefits that came back, the insurance says the patient still owes $53, and we as in-network providers are contracted to present this information to the patient. The patient did not want to pay this even though the exam was done and as a courtesy we waived the $53 before this complaint just to give good customer service. We conduct ourselves with professionalism and follow the best practices in standard of care. We have proof of xrays and probings and a comprehensive record of data with the exam taken. Until it comes back in letter form and writing we cannot verify what an insurance representative might have told her.  As per HIPPA we did add attatchments of her records, but if requested under consent we are happy to show proof of records including the exam, collection of existing restorations, probings, a full set of xrays, and diagnosis. Please contact us if there are any more questions. We pride ourselves in the quality of service we give. Thank You. 

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