ComplaintsforWildwood Dental Care

• Initial Complaint

  08/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  My husband, **** ******* had a tooth extracted on 4/25/23. He was told he was required to pre-paid for the entire procedure of, $251.39,before they would bill our insurance United Concordia. United Concordia paid $179.95, on 5/4/23. To date Dr.M**** has refused to reimburse us $140.07. Dr.M**** is a PPO dentist with United Concordia. I have gone to Dr.M**** office spoke with Mona Acct Coordinator, Tito Office Mgr., have spoke to Millie in the insurance billing department. I have sent emails and a letter requesting reimbursement. I was told by Millie that they did not bill United Concordia for all procedures, because they were not covered. In my 30+ years as a FL insurance adjuster, did I ever hear of provider not billing an insurance company for all procedures. I have gotten nothing but the round around from Dr.M**** and his staff. This dentist is billing senior citizens over a 100% for procedures and claiming the insurance company is not covering, all the while pocketing the money. This amounts to consumer fraud. We simply want what is legally do and owing to use.

  Business response

  09/26/2023

  I hope this message finds you well. We appreciate the opportunity to address the recent complaint filed against our dental office, which is identified by Complaint ID ********* We take all feedback seriously and are committed to resolving any concerns our patients may have.
  
  Upon receiving the complaint, we conducted a thorough investigation into the matter. Our records indicate that the complaint was related to a billing matter in which the patient felt that she was due a certain refund and wanted a refund immediately. We were working diligently to work with insurance company and get some answers on certain claims. Upon the patient reaching out, we reached out to explain the matter at hand. The patient has been disputing a certain refund amount that does not reflect on our end. Although the patient’s ledger does not reflect the amount she requested to be refunded, we went ahead and sent the amount that they believed was due to them to help resolve the matter. On our end we are in the process of disputing a denial with the insurance and it is still pending. We understand the frustration that this situation may have caused, and we sincerely apologize for any inconvenience experienced by the patient.
  
  After our investigation, we discovered that we have pre-collected on a procedure that was thought is needed to be done and that insurance might not cover for it. After a consultation with our endodontics, he was able to save her tooth with root canal treatment. That created some credit in the patient ledger, we explained that to the patient and informed her that what is requested to be refunded is not reflected in our ledger, but as we indicated earlier, we still went ahead and refunded her what she was demanding. Additionally, we have reached out to the patient directly to address their concerns and offer a resolution.
  
  At our dental office, patient satisfaction is of utmost importance to us. We continually strive to improve our services and maintain the highest standards of care. We value the BBB's role in helping us ensure that our patients' experiences are positive, and we appreciate your assistance in facilitating this process.
  
  If you require any further information or documentation related to this complaint, please do not hesitate to contact us at 352-748-1880. We are committed to working closely with the BBB to ensure that this matter is fully resolved to the satisfaction of all parties involved.
  
  Thank you for your attention to this matter, and we look forward to your assistance in bringing it to a satisfactory conclusion.

  
  

  Sincerely,

   

  Tito A*****

  Regional Manager

  CC: Dr. Ammar M***** ***
  
  

  Business response

  10/09/2023

  Understood Mrs. ******* You and your husband have a family file account which on our end the accounts go hand in hand when it comes to the financials. 

  Customer response

  10/10/2023

  We do not want to have the complaint against Dr.M**** closed concerning a refund for date of service of 4/25/23 and amount of $140.07. 
  I have attached the Excel Spreadsheet along with Treatment Plan for myself (***** ******) wherein I was owed a refund of $3,575.70. Dt.M**** did in fact reimburse us, after a lot of run around by his staff.

  
  You can see on the Excel Spreadsheet that the date of service of 4/25/23, is not listed, nor is the refund due and owing of $140.07.
  This new staff of Dr.M****** office is price gauging senior citizens and then giving us the run around to avoid having to reimburse for services we were required to pre-pay, before insurance was applied. If the staff even sent the billing to the insurance companies.  Please note I worked in Insurance Claims for well over 30 years in Florida and what this staff is doing is wrong. 
  We contend that we are still owed a refund  $140.07 for date of 4/25/23.  As previously stated Dr.M****** staff lacks specificity in addressing why we have not received this refund. 
  ***** ******

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