ComplaintsforModern Family Dentistry

• Initial Complaint

  03/20/2023

  Complaint Type:

  Billing Issues

  Status:

  Unresolved

  More info

  I WENT TO THE ABOVE PROVIDER FIRST BELIEVING THE OFFICE WAS IN NETWORK. AFTER RECEIVING AN ESTIMATE AND THEN BEING TOLD I WAS OUT OF NETWORK BUT STILL NOT TO WORRY FOR I HAD OUT-OF-NETWORK BENIFITS WHICH THE OFFICE WOULD FILE ON MY BEHALF. I AGREED TO HAVE THE WORK COMPLETED AND TO PLACE IT UPON MY CARECREDIT ACCOUNT. IT WAS NOT UNTIL WAITING MONTHS THAT I FINALLY REACHED OUT TO DENTAQUEST (THE DENTAL INSURANCE) AND IT WAS EXPLAINED TO ME THAT I HAD NO OUT-OF-NETWORK BENIFTIS AND THAT NO REIMBURSEMENT WOULD BE ISSUED. I THEN CALLED AND LEFT A DETAILED MESSAGE TO THE OFFICE OF DR. M******** CONCERNING THE ISSUE AND THE OFFICE FAILED TO RESPONDE. I THEN FILED A COMPLAINT AGAINST DENTAQUEST THROUGH CGA AND DETAQUEST RESPONDED WITH THE ATTACHED DOCUMENTS. I NOW TEND TO BELEIVE DENTAQUEST FINDINGS FOR DR. M********'S OFFICE TO DATE HAS FAILED TO CONTACT ME CONCERNING THIS ISSUE. I ALSO WOULD LIKE TO STATE THAT DR. M******** SWAYED FROM HIS ORGINAL PLAN OF TREATMENT FAILING TO FILL A GAP BETWEEN 2 TEETH AND IT WAS NEVER EXPLAINED TO ME THAT HE WAS NOT GOING TO PERFORM THE ORGINAL AGREED UPON PLAN OF TREATMENT UNTIL I QUESTIONED THE OFFICE STAFF AND DR. M******** CAME IN TO EXPLAIN WHY (I PERSONALY FELT THAT WAS WRONG FOR IT SHOULD HAVE BEEN EXPLAINED TO THE PATIENT PRIOR TO SERVICES SO AS BOTH PARTIES COULD AGREE UPON). DR. M******** DID TELL ME THOUGH THAT IF THIS PLAN OF CORRECTION CAUSED TOO MUCH INTERFERIENCE WITH MY CHEWING CAPABILITY TO RETUNR BACK TO HIS OFFICE. NEEDLESS TO SAY I WILL NOT BE RETURNING FOR ANY FURTHER WORK TO BE PREFORMED BY THIS OFFICE AFTER THE TURN OF EVENTS AND I NOW GO ANOTHER ISSUE WHICH FURTHER MONIES MUST COME OUT OF MY POCKET. NOW THAT I THINK BACK I REALLY FEEL THIS PRACTICE WAS WRONG FOR MY INITIAL COMPLAINT THAT BROUGHT ME INTO THE OFFICE WAS PERTAINING TO THE GAP BETWEEN MY TWO TEETH AND HOW FOOD PARTICLES WOULD GET CAUGHT IN BETWEEN. I HAVE SCANNED MY DOCS FOR YOUR REVIEW.

  Business response

  04/20/2023

  Our office provided services for this patient 12/5/22 for a new patient exam, and 12/13/22 for two crowns on teeth #2 and #31. The treatment plan presented to the patient showed ZERO coverage for all services planned and he still signed the treatment plan on 12/5/22, an entire week before services were rendered. Not only did this patient fail to inform us that he was in any way uncomfortable proceeding with treatment within the week up to his appointment, but we also did not receive any correspondence from the patient after his visit. We would have gladly explained AGAIN that this patient was out of network. I have attached the copy of his insurance card that we clearly wrote "out of network" on before returning it to patient. Mr. ****** was aware we were out of network before and during both visits to our office. It was discussed before verifying his policy, that some insurance companies offer out of network benefits. It was also explained after verifying that his plan was not one of them . Our office manager was sympathetic and accommodated the Mr. ****** by waiving the two same-day-crown fees of $262 per tooth. You will see all of this information on the treatment plan attached. The treatment plan is not dated next to his signature but it was time stamped when scanned into his chart the same day of his appointment on 12/5/22. I have also attached the emails between myself and Mr. ****** before scheduling him to reassure him we would provide the quality care he was seeking. We have a moral obligation to express that insurance benefits often dictates the time and place in which a patient receives clinical treatment, and in Mr. ******'s case, as a cancer patient, we expressed the urgency to removed the decay from teeth #2 and #31 and he understood. 

  Allison S*******

  Modern Family Dentistry

  **********

  Business response

  04/20/2023

  Our office provided services for this patient 12/5/22 for a new patient exam, and 12/13/22 for two crowns on teeth #2 and #31. The treatment plan presented to the patient showed ZERO coverage for all services planned and he still signed the treatment plan on 12/5/22, an entire week before services were rendered. Not only did this patient fail to inform us that he was in any way uncomfortable proceeding with treatment within the week up to his appointment, but we also did not receive any correspondence from the patient after his visit. We would have gladly explained AGAIN that this patient was out of network. I have attached the copy of his insurance card that we clearly wrote "out of network" on before returning it to patient. Mr. ****** was aware we were out of network before and during both visits to our office. It was discussed before verifying his policy, that some insurance companies offer out of network benefits. It was also explained after verifying that his plan was not one of them . Our office manager was sympathetic and accommodated the Mr. ****** by waiving the two same-day-crown fees of $262 per tooth. You will see all of this information on the treatment plan attached. The treatment plan is not dated next to his signature but it was time stamped when scanned into his chart the same day of his appointment on 12/5/22. I have also attached the emails between myself and Mr. ****** before scheduling him to reassure him we would provide the quality care he was seeking. We have a moral obligation to express that insurance benefits often dictates the time and place in which a patient receives clinical treatment, and in Mr. ******'s case, as a cancer patient, we expressed the urgency to removed the decay from teeth #2 and #31 and he understood. 

  Allison S*******

  Modern Family Dentistry

  **********

  Customer response

  04/20/2023

  
  Complaint: ********
  
  I am rejecting this response because:  This office has bold faced lied not only to the BBB but no involving myself.  Nobody wrote on my insurance card that I was out of network and or that no reimbursement would be made.  If this was the case, then I surely would have sought a in network provider to avoid hundreds of dollars in out-of-pocket expenses.  If something does make sense then guess what?  It never happened.  The office manager clearly stated to me that this provider would do the direct billing for me as I was out of network.  This office clearly lacks the medical morals which should be provided to a patient.  You mentioned that I lacked to sign a medical document but yet it was scanned, and time stamped.  Really, really now!  That does not hold water without the patient's signature, and I have never heard anything so insane in all of my life as writing on one's insurance card that no benefits are being provided and given back to the patient.   I have worked nursing all of my life and have never heard of such a practice.  As far as my plan of care it was changed the day of service and not even told to me until I questioned the staff as to why the procedure had changed from what I had originally discussed with this dentist.   The delay in contacting the office with an issue was due to the patient waiting for reimbursement and when it did not come, and I called the insurance company was told the truth about this provider never even called when I was told they had to verify my out of network benefits.  I once again have never met a more unmoral doctor's office as this one and if need by will bring this ludicrous office before the Board of Dentistry as I am sure they would find this all too interesting of a case.  
  Sincerely,
  
  *********** ******

  Customer response

  04/20/2023

  
  Complaint: ********
  
  I am rejecting this response because:  This office has bold faced lied not only to the BBB but no involving myself.  Nobody wrote on my insurance card that I was out of network and or that no reimbursement would be made.  If this was the case, then I surely would have sought a in network provider to avoid hundreds of dollars in out-of-pocket expenses.  If something does make sense then guess what?  It never happened.  The office manager clearly stated to me that this provider would do the direct billing for me as I was out of network.  This office clearly lacks the medical morals which should be provided to a patient.  You mentioned that I lacked to sign a medical document but yet it was scanned, and time stamped.  Really, really now!  That does not hold water without the patient's signature, and I have never heard anything so insane in all of my life as writing on one's insurance card that no benefits are being provided and given back to the patient.   I have worked nursing all of my life and have never heard of such a practice.  As far as my plan of care it was changed the day of service and not even told to me until I questioned the staff as to why the procedure had changed from what I had originally discussed with this dentist.   The delay in contacting the office with an issue was due to the patient waiting for reimbursement and when it did not come, and I called the insurance company was told the truth about this provider never even called when I was told they had to verify my out of network benefits.  I once again have never met a more unmoral doctor's office as this one and if need by will bring this ludicrous office before the Board of Dentistry as I am sure they would find this all too interesting of a case.  
  Sincerely,
  
  *********** ******

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