ComplaintsforUniversity Dental Associates

• Initial Complaint

  12/28/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On 8/18/22 I went to UDA (contracted w/UHC) with a loose crown. Dr. ****** pulled the crown off so that I was missing a tooth. I was told I needed a bridge. On 9/6 root was extracted and I was fitted for my temporary flipper tooth (D5820) until I could get a bridge. UDA Billed UHC for a partial denture (D5284) instead. A pre-treatment estimate was approved showing $1176 would be allowed and I would be responsible for $588. Despite this I was forced to pay $2179.10 on 10/12 when I was prepped for the bridge. On 1025 I received my EOB showing UHC had denied to provider liability so I had no liability. I called UHC to have the claim reconsidered knowing I had coverage and UDA should be paid. On 11/1 I called UDA to check that the claim was being resolved and was instead told I had to pay 747.90 at my appt the next day or I wouldn't receive my permanent bridge. I advised I would be there and pay. I arrived on time for my 8 am appt and pd the balance. I was then told they cancelled my appt and I would have to be worked in, which took about an hour. UHC paid the provider the $588 they were advised they would be due and the EOB shows I was only liable for $588. I have called UDA multiple times to get my refund and they refuse to give it to me and won't return my calls. They don't agree with UHC reimbursement which is a matter between them and UHC and I should be refunded the amount I was overcharged. They now have $3515 in payment for a service UHC said they should only receive $1176. Dr. ****** texted my cellphone on 11/29 @ 5 pm from his personal cell to advise my insurance doesn't cover the bridge I receive. This is not true. My comprehensive coverage pays 50% for a bridge. I believe UDA incorrect billing of the temporary tooth and inappropriate records submitted to support the service is the reason UHC paid what they did. Again, this is between UHC and UDA as my EOB clearly shows I only owe $588. Please help me to get this refund I am due.

  Business response

  01/05/2023

  Ms. ***** consented to the partial denture (5284 code) and signed the treatment plan showing the full fee on 8/18/22 before ever having the partial made (9/6/22). She also signed an informed consent on 9/27/22 (see attached) which states she was happy with the final product. She signed the financial policy on 8/18/22 stating that she understood any unpaid balance from insurance become patient  responsibility (see attached). The nesbit was made in order to give the patient teeth in the area for the remainder of the year and she stated when her benefits renewed in 2023, she would proceed with the bridge. However, the patient chose to proceed with the bridge on 10/12/22, aware that the bridge would not be covered by her insurance. The patient was given autonomy over her treatment and Dr. ****** providing a high quality of care for Ms. ***** while ensuring she was provided informed consent and an estimate treatment plan before ever beginning her restorative care. As a courtesy, we have reversed the code from 5284 to 5820 as requested by Ms. ***** in order to satisfy her complaint. Her account currently has a credit of $862.00 from the 5284 and a balance of $467.00 coming from the 5280 code that has been swapped out. We will apply the credit to the balance leaving her with a refund of $395.00. 

• Initial Complaint

  09/28/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had a filling done on my front tooth on May 11th. The filling fell out around the end of Aug. I went into the UDA office in Clemmons the beginning of Sept about the filling coming out. They told me I need a crown put on. Which was going to be around $1600. I do not have dental insurance. I called UDA @ Robinhood and setup a time with the doctor that did the filling in May. My appointment was 9/28 I was told I would have to pay $285 dollars to have another filling done. Which I should not have to pay to have another filling done since the filling didn't even last over 3 months. They should do a better job. I have only had issues with UDA so I will be finding me another dentist.

  Business response

  09/29/2022

  Ms. *****, The QI Board discussed your orthodontic history with Dr. T***** when the tooth was first restored, and it was noted that there was no attachment on this tooth during your Invisalign treatment. Dr. T***** restored this tooth as a courtesy in April 2022, and did not charge you for it, even though he did not feel it was a direct result from the Invisalign. Both Dr. T***** and Dr. S**** have stated that the tooth did not chip from the Invisalign, and even discussed other habits than can contribute to this such as nail biting. Dr. S**** restored the chip on May 11, 2022 and did not charge you for it. She went over in detail about the risk for chipped fillings on anterior teeth and how parafunction habits, such as nail biting which you acknowledged doing, can lead to high risk for chipping and fracturing the incisal edges of natural teeth and composite material. Dr. P**** recommended a crown on this tooth on September 9, 2022, considering continuing to restore the edge with composite is never a long-term fix. These will continue to chip and break over time and/or discolor. This is why it was discussed on May 11th, that the filling would be redone at no charge one last time and any additional chipping or fractures would need to be your responsibility as this isn't considered a clinical care issue, as much as it is a material and or parafunctional issue. You also signed the informed consent on May 11th and September 28th that stated you understood the high risk nature of composite material for chipping and fracturing when placed on anterior surfaces of the teeth. You were informed prior to your visit on September 28, 2022, that the out of pocket cost would be your responsibility to pay for the filling if you chose to proceed with that method of treatment. We completed the filling on 9-28-22 without prior payment for services therefore, the balance on your account will remain your responsibility. Thank you. 

  Customer response

  09/29/2022

   I am rejecting this response because:  I had no issues with this tooth until I had the invisalign.  There was an attachment on that tooth because when it came off I showed it to someone so they seen it as well.  Also last Friday I was asked from the office Manger if I wanted QA to call me and I informed her yes and still have not received that phone call in regards to this issue.  If this issue can't be fixed with the BBB then I will handle it with the dental board.  
  
  
  

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