ComplaintsforABQ Endodontics

• Initial Complaint

  04/13/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  On 29 March 2022, ABQ Endodontics gave an estimate for exam & root canal of $1,866.03. $401.95 for an exam & $1464.08 for root canal procedure. ABQ promised they would submit a claim on my behalf for charges. They photocopied my insurance card & acknowledged that they did not have a standing agreement with Presbyterian senior care insurance. I said I would go forward with the procedure on the basis they would submit to my insurance as promised. They reneged on the promise saying they would not submit on my behalf. On April I complained to Office Manager, Ginger. 

  Business response

  04/27/2022

  Thursday, April 21, 2022

   
  Claim ID #********
   
  Dear ****** *********,

  Client #******** presented to our office for an examination on 3/29/2022 for an evaluation of a tooth in need of root canal. He had communication with three people in our office. The first person was Jennifer, via telephone conversation. Jennifer helped to set his initial appointment. In conversation with, ID #********, she asked him about his insurance? ID #******** he told her he would find out if his insurance could be used in our office? {(Please see snip of screen shot, with appointment notes). (We have appointment notes that we can fill as we are on the phone with the patient. This helps us to have better communication with the patients. There are so many dental insurances, and we are in network with only a handful)}. He was told that and understood that he would be responsible for the full fee in our office. He was prepared to pay 401.95 for the exam and if needed the treatment, he was prepared to pay $1614.88. He came in for his examination and was still uncertain of his dental insurance, he mentioned to Kina (second contact) that he may have Senior Presbyterian dental. We are out of network with Senior Pres dental, but will offer a 10% discount (off of our full fee) to help some of the seniors out to help off-set the cost of their treatment in our office. He was given a 10% discount off of his examination.

  When he set up the appointment for his treatment, Kina discuss the cost of the treatment, and in doing the estimate quote, she again added the 10% discount Pres. Senior Plan, for his upcoming appointment.
  When he came in for his treatment (root canal therapy), when he was checking out, he had the conversation with Kina. Kina told him if he got that information to us we could try and file for him, but she said if it is dente quest, we are out of network. He stated that he provided a dente quest insurance card, but we do not have that card scanned in his file.
  As he was leaving she asked him to call her and get the information to us; so that if we could, we would help file the insurance for him. 
   
  On 4/1/2022 he called and asked for the Office Manager, I told him I was Ginger and I could help him (3rd contact). He told me he felt that Kina mislead him regarding dente quest. I explained to him that we are not contracted with the State for any Medicaid or Medicare plans, nor do we have a contract number for the State. I explained without a contract number thru the state, claims tend to get bounced back and or denied. At that time, I mentioned to him that he received a 10% discount not only for the exam, but for the root canal therapy. He said that he appreciated the discount and was very pleased by the treatment that Dr. P****** provided for him, to get him out of pain.
  He stated that he was in pain, and needed to have the treatment done anyway.
  I also told him if he could find out what we needed to do, we could help him with the paperwork. As a courtesy we file paperwork to traditional insurance for all patients.
  He talked over me the entire conversation telling me that I just needed to admit that Kina made a mistake. I said I was not in earshot of their conversation. Trying to focus on helping him get his claim submitted. He said, “Fine, you think I’m lying”! I said No, I did not say that nor did I imply that. He let me know that he was going to contact the Better Business Bureau, I told him that was fine he should do what he needs to do.
  We are more than happy to get paperwork filed for him. I told him that at the end of our
  conversation (4/01/2022) and he has yet to contact our office to provide that information to us.
  In good faith we provided treatment for him and extended a 10% discount for not only the
  evaluation but for the treatment as well, to help him with the cost of treatment and to get out of pain.
  I attached the copy of his chart notes and the Phone set up screen without blocking out his name, so that you can see conversation as well as the commlog.
  Again, we are more than willing to help him with the paperwork, He still needs to provide his dente quest insurance card. Please let us know how we can help Client #********.
   
  Respectfully,
   
  Ginger M*****
  Office Manager
  ***** ******* ** *** ** **
  Albuquerque, New Mexico 87111 
  

  
  

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