ComplaintsforPediatric Dental Group Inc

• Initial Complaint

  07/22/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On December 22, 2023, my son visited the dental office(The Pediatric Dental Group Framingham at *************************) for a regular teeth cleaning and was asked to take a full-mouth **ray, despite having provided a panoramic **ray taken from July 20, 2023. The front desk senior staff assured us that it would be covered by the insurance. My son had the **ray on that day but the teeth cleaning was rescheduled and done on January 2, 2024. On January 2 at the dental office, the front desk staff verified the coverage with BCBS in front of us for my sons wisdom teeth extraction surgery and presented us the proposal for a total of $1184.6, which included 3 charges for 3 teeth and one charge for analgesia. They ensured us $127.6 patient payment was all cost to us. We accepted and paid at the office before the surgery.On June 23th, 2024, we received a bill for $186.4 and spoke with ******** from ******************* We were informed that the charges were x-ray $102 and oral evaluation $65 from 12/22/23, which was declined by insurance due to out of frequency, and $19.4 unpaid for analgesia from 1/2/24 visit.We wish to highlight the following concerns:We were assured by the staff on Dec 22nd that the service would be covered by the insurance. Otherwise, we would have waited until January 2, when the teeth cleaning was actually performed.BCBS statement shows an oral evaluation charge of $75.73 was paid on January 2. ******** said it was for the surgery while the signed proposal only had four charges including a $19.4 adjustment for analgesia, with no oral evaluation charge.I strongly believe that these practices mislead patients regarding charges and withhold relevant information from treatment proposals. I request BBB to help resolve the billing discrepancies.

  Business response

  08/01/2024

  We received a complaint from your organization originating from a ************. The complaint states questioning the fees billed to the account. Of the $186.40, here is a breakdown of this account.
  
  $102.00- Full mouth X-rays taken. The general dentist who performed the exam needs this form of radiographs for proper diagnosing as panoramic radiographs do not provide what is necessary. As a courtesy, we have adjusted this off of the patient's account since the father did present with an X-ray that happens to share the frequency with what was needed. This has also been refunded to the original form of payment.
  
  $65.00- Comprehensive exam. Per the patient's insurance, they only allow one comprehensive exam every 5 years, irrespective of changing dentists. Therefore, it is the patient's responsibility to understand the limitations of their insurance regarding what is covered and what is not.
  
  $19.40- Co-pay for nitrous oxide/ oxygen sedation.
  
  After the adjustment/ refund, the patient only owed $84.40, which has already been paid by the patient. If there are any other questions, please let me know.
  ************************
  Chief Compliance Officer
  ************

• Initial Complaint

  01/03/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  On 10/31/2021 I took my son for his routine dental exam. We had no change in our dental coverage. just like in prior years, the dental technician asked me if I wanted him to have dental sealants on his teeth and I replied yes as he has had them every single year for the past few years and I have not had to pay for them as my insurance has covered them fully. I was NOT made aware by the technician that 1) that there's a possibility that the insurance would not cover this because he was not over a certain age and 2) that I was responsible for the charges anything that the insurance did not cover. It was only after the treatment was done that I was made to sign a document for the treatment that was provided BUT event then, I was ONLY verbally informed to just made to sign a document saying I acknowledged that the following treatment was provided. A few weeks later, the dental practice sent me a **** for $816 for the sealants ($100 per tooth) stating that the insurance denied coverage. I have spoken to the dental two times, on 12/1/2021 and on 12/16/2021. Both times, the billing department said that they will call me back with a resolution but to date they haven't. The billing department person on 12/16, **** told me that they were sorry that this occurred and that I am responsible for checking what is covered or not but without knowing what treatment is going to be done until the day of OR given time to do this at the appointment I cannot be held responsible for this ****. IF they had told me ON the day that they did this that there is a possibility that the insurance would not cover I would have OPTED NOT to do the treatment. That would have been MY CHOICE. They did not give me that choice that day. Instead they deceived me. They also neglected to inform me about the treatment and have me sign the treatment papers before the treatment was done. I have tried to work this out with the dental office and they are not calling me back as promised.

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