ComplaintsforDiadem Family Dental

• Initial Complaint

  10/31/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Beginning of, I believe, November 2021- February 2022, I received dental services through Diadem. From the beginning I inquired about them being in-network and they told me that they were. Being that I work in healthcare, this is a question that I am sure to answer. I continue going there for dental work, after being told, by then, that they were in network with my dental insurance. I even paid a percentage of my last service, upfront, and the receptionist told me at that time, that I would not be billed any additional as they were “in-network “. Now they are billing me for over $300 and have sent my account to a collection agency , later stating that it’s because they were out of network. Obviously, they are not clear as to who they are in network with. I do not feel as though I am liable for the account.

  Business response

  11/07/2022

  S. ****** joined this dental office in February 2021 under Dr. ***** ******. The practice was not In Network under ******** with Dr. ******. Dr. ******* purchased the practice March 2021. Diadem Family Dental continued to be an Out of Network provider with ********. 
  
  Correspondence with Patient
  Patient seen 10/7/2021 for a Limited Exam, Xray, and 2 fillings. All treatment completed on Oct 7, 2021. Patient paid $131 at Date of Service.
  December 1, 2021- Patient was called to schedule cleaning. Patient requested to not schedule at this time due to insurance not paying a lot on her recent bill.
  January 14, 2022- Patient called about balance. Explained ******** downgraded her procedures. Explanation of Usual and Customary Rate and Diadem Family Dental being an Out of Network provider explained to patient the reason ******** gven for not paying 100% of office fee. Patient states she was not aware we were Out of Network. Patient states she will call insurance company to dispute. Patient will call office once she calls ********.
  February 21, 2022- Patient was called about balance. Left message. Patient called back. Patient states she called ******** and they said they will send additional funds for procedures rendered on Oct 7, 2021- Called ******** to confirm. They stated no additional payments will be paid on the patients behalf for Treatment on Oct 7, 2021. Patient called back. Informed of conversation with ********. Patient states she will call ******** to do additional investigating. Patient given name of ******** rep and Reference Number for call. 
  
  Patient sent Billing Statements on the Following Dates: 
  
  11/19/2021
  12/23/2021
  2/4/2022
  2/20/2022
  3/4/2022
  4/1/2022
  5/6/2022
  6/3/2022
  7/1/2022
  *Patient's account sent to collections agency Summer 2022 due to non-payment. *
  Patient’s insurance coverage states that we legally can bill patient $461.40 for Services completed in Oct 2021. Patient paid $131 on day of service, leaving a balance of $330.40. Once patient’s account was sent to Collections agency, additional $30 added to account for Collections Fee. Total balance to date is $360.40.
  

  Patient has been aware of balance but has not patient paid after multiple attempts to contact her for payment.

  We are now requesting payment at this time to close patient's account.
  
  
  Additional Information: Patient still has outstanding balance of $71.00 with Dr. ***** ****** for services rendered in February 2021. No treatment rendered at this office where ******** paid 100% of office fees.  Statements from Dr. ***** ****** sent on the following dates:
  8/5/2021
  9/10/2021
  11/5/2021
  1/12/2022
  2/17/2022
  4/6/2022
  5/26/2022

  
  

  Customer response

  11/07/2022

  
  Complaint: ********
  
  I am rejecting this response because: the information that I received from the day that I agreed to accept service was dishonest. Had the receptionist or whatever her title explained that they were out of network, I would have never agreed to the service. I asked more than once about them being in network with my insurance. I later contacted my insurance after receiving bills and that’s when they told me that the dentist was not in network. I work in healthcare and I know what questions to ask before receiving service which is what I did. The office was dishonest and I do not agree to the bills. 
  
  Sincerely,
  
  ******* ******

  Business response

  11/08/2022

  S. ****** called office at 2pm on October 7, 2021 and scheduled a same day appointment for 3pm for a limited exam.

  Staff member (*******) scheduled appointment for S. ******. ******* aware that office was not in network with ******** under Dr. ****** and Dr. *******. Staff member would not have informed patient that Diadem Family Dental or Dr. ***** ****** are In Network with ********. 

  Patient informed of fees for restoration #19 before treatment was completed. Patient signed treatment plan agreeing to fees. Patient informed of additional restoration needed on Tooth # 18 and requested to have treatment completed and to be billed. No deceptive business practices were used with patient. Patient was informed of all treatment needs and agreed to them (per signed treatment plan).

  Patient responsible for office fees. Collections process will continue until bill paid in full to Diadem Family Dental in the amount of $360.40.

  Patient also encouraged to pay Dr. ***** ****** for treatment completed in February 2021. Patient balance with Dr. ***** ****** is $71.

  Patient has two outstanding accounts for treatment at **** *** **** **** in 2021 by Dr. ******* and Dr. ******. 

  Patient can call to make payments with credit card or send a check to **** *** **** ****, Ste A., Durham, NC 27704. Address check for Dr. ****** in the amount of $71 if you would like close the account. Address check to Diadem Family Dental in the amount of $360.40 if patient would like to close the account. 

  If amount not paid to Diadem Family Dental, collections efforts will continue to be made by Third party company ********** on behalf of Diadem Family Dental. 

*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. ↩