ComplaintsforCronin & Czarnik Orthodontics

• Initial Complaint

  07/25/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I was told in September or October of 2021 that my insurance covered braces for my daughter. The dentist told me the schedule the appointment for ******* though so I did. She went in in December of 2021 just to check everything out before they actually put the braces on. Come ******* the day after applying the braces they call me and tell me my insurance is not covering the braces and that I would have to pay out of pocket. I called ******** and asked them what was going on and they said the office never sent in a claim for approval since things were changing in the new year and the office knew about the changes in December.

  Business response

  08/08/2023

  To Whom It May ******************* is very unfortunate as we have spent hours of time trying to do right for this family. Unfortunately the insurance the filer is referring to from 2021 changed its policies starting January 1st, 2022 and no longer covers services (procedures codes) that were previously approved. This is frustrating for all parties involved because the business did its due diligence and got prior authorization and approval for said procedures. Since the procedures were not completed until after January 1st, 2022 they were no longer covered.  This was a universal change that affected many patients at all dental offices across the nation. We wanted to help patients who were affected by this change so we offered significant discounts to all treatment fees including to the treatment we performed on the parties involved in this complaint.  We have exhausted all options with the insurance as they will not bend the rules on this change. We were extremely fair and just in offering the family a large discount purely out of empathizing for their situation. We have reached out to the filer of this complaint on several occasions offering them help to continue the dispute process and send further authorizations to their insurance company. The family has declined wanting to proceed with any further services at our office.
  

  Thank you for your time and consideration in this matter.

   

  Customer response

  08/08/2023

  Per dentaquest the office new about the change in codes in December and they still went ahead and proceed it with the braces in January instead of informing me until after the braces were on. 

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