ComplaintsforSmile Design Dental Ctr

• Initial Complaint

  09/18/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Let me start off by stating this complaint is in no way a complaint against *** ***** *******, for he is a very good Dentist. My only complaint is with the office help and management at Smile Design, ********* ****** *** *** ********** who I was informed are all or part owners of Smile Design. On August 23, 2023, I went to Smile Design to get my teeth cleaned from an appointment I had made in March,2023. It was my third(3) cleaning for 2023 which my insurance policy with ***** ****** states that since I previously had a deep cleaning of my gums, I now can get up to four (4) cleanings per year that I have been having with Smile Design since my deep cleaning. When I was finished with my appointment, I was told I owed $109.00 and that I was only eligible for two (2) cleanings per year. It totally got me off guard so I went ahead and paid the $109.00 and they told me if the insurance paid them, they would refund me the money. I went home and called ***** ****** and was told that I indeed was eligible for four (4) cleanings per year because of my deep gum cleaning. I called Smile Design back then, what ***** ****** told me and was told by Smile Design that I talked to the wrong person. I again called ***** ****** and while going through the process of getting to talk to a real person I got a message that told me that my claim that Smile Design had been approved. When I did get to talk to a person, they again told me that I indeed was eligible for four (4) cleanings per year. I called Smile Design back and they still contended that I only get two (2) cleanings per year and this was my third (3) cleaning for the year and needed to be charged. That was all on August 23,2023 and as of September 18,2023 I have not gotten any money returned. I got a statement in the mail on September 11,2023 from ***** ****** that the $109.00 was paid to Smile Design. I called ***** ****** on September 11,2023 and told them I had gotten their statement and that I had not gotten any money retuned from Smile Design. ***** ****** then called Smile Design, who was still contending I could only get two (2) cleanings per year without paying out of pocket. I was then told by ***** ****** again that because I had previously gotten the deep cleaning, I was eligible for four (4) cleanings per year. I cannot understand how Smile Design doesn’t get it because I had gotten the deep leaning from them and I had previously gotten four (4) cleanings per year before, so everything had to be in their records, I can only assume the office help has to be completely incompetent or there needs to be an investigation into what’s going on. I do like *** ******* as a Dentist and I do not want to find another dentist, but there is a definite problem with the office help and there lays the problem that Smile Design is owned by ********* ****** which is owned by *** a leading global investment firm. After my teeth cleaning, I agreed to have a fluoride treatment performed by the Hygienist for my cost of $30. I assumed all of my teeth were going to be treated and not a slam bang treatment of only the teeth in the front half of my mouth and not the back half. I had never had a fluoride treatment before so I wasn’t sure what to expect, but after I thought about it and inquired from other sources, I indeed had a poor treatment and I feel I shouldn’t be charged for that either. I am not talking about *** *******, but all the different levels of offices and the help in the offices, are performing at very low-level standards. Any help in settling this dispute with Smile Design********** ********** *********** will greatly be appreciated.

  Business response

  09/25/2023

  Patient ***** ****** visited our office August 23,2023. The periodontal maintenance that he has serviced to him we  received a fax from his insurance that stated code D4910 was covered 2 times a year. We collect copays and estimated  payments on date of service based on what patients insurance provides us.  After patient called our office with this complaint that he receives 4 a year we called the insurance to directly speak to a person. We were told that the patient is associated with a ******* ****** ******* ***** program that will provide 4 maintenance visits a year, but that he has to reapply for that. So we then confirmed with the representative, that the claim we sent on his date of service would not be paid as of right now until he reapplies. She confirmed that .  She stated when he reapplies the claim will be paid out.  This is notated with dates and insurance representatives name.  We tried to explain this to *****.  The claim was paid to us  9-6-2023, his refund was sent out by our refund department 9-13-2023. As of his fluoride treatment ***** received a complete fluoride treatment on all teeth confirmed by his hygienist .

  Customer response

  09/29/2023

  Complaint: 20621756
  
  I am rejecting this response because: I have sent the attachment that clearly states from ***** ****** that my insurance did indeed cover my teeth cleaning.  Does Smile Design have anything in writing that ***** ****** was not going to cover my teeth cleaning on 8-23-2023, and not just a general form from Dental Dental that was not talking about my "Healthy Smiles, Healthy Lives" plan which they should have in their files.  My deep cleaning was done in June 10, 2014 and ***** ****** has been paying for 4 cleanings per year ever since. I have had absolutely no problem with my insurance company paying.  The only problem I've had is to get Smile Design to accept my insurance.  Apparently Smile Design was given bad information from someone  at ***** ****** that was returning bad information.  All that information about I had to reapply was not true.  As for as the fluoride treatment I received, I felt her applying the treatment in front half of my mouth but nothing on the teeth in the back half of my mouth.  Of course the hygienist is going to say she did a perfect job and how can I prove otherwise.  I only know what I felt in my mouth and not having had a fluoride treatment before I didn't know exactly what a treatment amounted to.  No I can't prove any of this beyond a shadow of a doubt, the only thing I witnessed was a very poor business practice.  This is the only Doctor's office I have ever had to pay in advance and then wait a month to get my money back because of incompetent help.
  
  
  
  Sincerely,
  
  ***** Foster

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