ComplaintsforJames R. Wright DMD, PSC

• Initial Complaint

  02/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I received a bill totaling $169.40 from Wright Dental Center dated 2/23/2023. I called and spoke with the person who does the billing and was informed that insurance didn't cover the cleaning because they claimed I was out of network at the time I received the cleaning in May of 2022. I was told the new office took over in June 2022 and was told that starting on May 23, 2021 that my insurance was out of network with ******* but we were never informed of this until September 30, 2022 when my fiance went in for a cleaning and declined after being told our insurance was out of network. They had a sign at the front desk informing patients that starting on June 1, 2022 that the practice had been sold and many of the insurance plans would now be considered out of network. The person who does the billing told me that they decided to cover the cost of the cleaning from October of 2021 but that I would be responsible for the cleaning in May 2022 even though I was never once informed that my insurance was out of network until September 30, 2022. Wright Dental Center neglected to inform either me or my fiance whether by phone call, text, email, letter that our insurance would no longer be in network. If I had been informed that we were out of network then I would've stopped going there and would've immediately sought out a new dentist that ******* was in network with. Neither one of us were aware of these changes and my mom and step dad who also went to Wright Dental Center were never told either until my fiance went in office and found out. I don't believe that I should have to be responsible for this bill because it was negligence on the part of Wright Dental Center for failing to inform me of the insurance changes. It doesn't make sense to tell a customer and hang up signs stating changes were happening in June 2022 but then also claiming that these changes began over a year prior in May of 2021. I hope this information is adequate enough.

  Business response

  03/15/2023

  To whom it may concern:
  

  In response to ******* ****** complaint, there are several matters that need to be clarified:
  

  Dr. James R. Wright II retired and sold his practice to Dr. James R. Wright III as of 6/1/22.  In doing so James R. Wright DMD, PSC closed on 5/31/22 and the Wright Dental Center – Union began 6/1/22.  (Both visits in question, pertain to James R. Wright DMD, PSC, nothing stated in the complaint should be addressed to the Wright Dental Center – Union.)
  

  James R. Wright DMD, PSC got out of network with ******* dental insurance effective 5/23/21.  The office made every attempt to notify all patients with ******* insurance prior to their appointment of that change.  That task proved to be difficult, as the dental software in use had no way of sorting patients based solely on insurance.  There was no way to go through a database of almost 50,000 patients by hand, and notify each and every person.  We did attempt to do that though.  As people called in we would let them know over the phone and we attempted to tell everyone as they came in as well.  In early May of 2021, a letter which I am including a copy of, was posted at the front desk where you would check in.  During Covid, with the barriers up, it was posted at eye level, approximately 5 foot high on the plexi-glass right where you check in.  As well as person by person we attempted to tell everyone about the change as they came in.  Literally thousands of people were told, some of which cancelled and others did not want to change regardless.  If she was not told at or prior to the 10/26/21 visit we do apologize, as I did to her over the phone when she called.  As I told her over the phone we discounted the balance from that visit as a courtesy.  The 5/16/22 visit has a balance due that we cannot discount, we cannot do both visits for $54.60 that does not come close to covering our expenses.
  

  When I spoke to ******* regarding the signs being hung up, I explained that there were two different signs.  There was an ownership change sign and the ******* change sign.  The sign hung up regarding the ownership change, was about the ownership change and insurance changes that followed and did get go up around June 2022.  The ******* out-of-network change sign went up in early May 2021.  Two completely different signs, put up for two different reasons, at two different times.  When the first sign was put up, Dr. Wright had not planned to retire yet.
  ******* posted that her desired settlement was a refund, which makes no sense because she did not pay the balance.  She indicated over the phone that she would not be paying it.
  

  This is an unfortunate situation all the way around.  The office has not yet been paid for work that was done almost a year ago, and the patient is having to switch dentist offices.  Which she did not want to do, and would not have done, if it were not for the insurance change.  Unfortunately, the insurance change had to happen, as the office was losing money on every patient treated due to rising costs of all materials used.  Ideally, ******* could have notified all impacted patients very easily, quite a few of the other insurance companies that we have since gotten out of network with have done so.
  

  Hopefully the information provided is helpful in your investigation of this complaint.  Honestly the complaint here should be with *******, as they only paid a total of $54.60 out of the $328.00 billed.  For services that are typically covered at 100%. (Most policies cover at 100% regardless of in or out of network) 

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩