ComplaintsforWestgate Family Dental

• Initial Complaint

  09/07/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I had an appointment at this practice on 8/31/23. I called a month prior to set up the appointment and gave them my insurance information. When I arrived, the receptionist asked for my insurance again, then let me know that they do take my insurance, but sometimes my insurance isn’t in network. She told me to go back and be seen while she figures it out. I definitely should have said no and waited until my insurance was 100% approved, but why would a private dental practice allow someone to be seen without being 100% sure they are covered and I already expected my insurance was accepted considering I given it to them a month prior and never got a call to say it wasn’t. While I was being worked on, the receptionist came in and let me know I in fact was not covered and asked if I wanted to pay in full or make payments. I was charged $343 as a new patient. She made sure to let me know they don’t usually do payment plans, but she felt “bad.” I should not have been told to go be seen without her approving my insurance first. This is the fault of the practice, not me. It was their mess up that I should not of had to pay $343 for. When I give a place my insurance, it is their job to run it. Not wait until I’m there and scam me of money while I’m being worked on! I did not even get a print out of her trying to run my insurance. Very disappointed and feel taken advantage of.

  Business response

  09/26/2023

  First, attached please find our HIPAA form, signed by the complainant, that clearly states "every effort will be made to help me with my insurance, but if they do not pay as expected, I will be responsible".  Second, it is our office policy to always advise the patient to verify their dental insurance benefits and we would never state during a phone call that we are in or out of network due to the fact that we work with hundreds of different policies on a daily basis.  It is impossible to know the details of every patients insurance policy and it is actually not our job to run it but a courtesy when we verify benefits and submit claims.  On the day of the complainants appointment, she presented 2 different insurance cards and stated that she "didn't know which one was her dental", therefore, we made a courtesy phone call to validate her dental benefits.  Again, it is not our responsibility to verify every patients dental coverage.  In the complainants customer statement that was filed she states we told her to go back and be seen while we check her insurance, therefore, the complainant was aware and acknowledged that she accepted treatment to begin without verification of her benefits.  Our office provides quality care and treatment for all of our patients, and we work very hard to verify all information that is presented.  Our office is an honest, family-oriented practice and we would never scam anyone, however, we do expect reimbursement for treatment that has been rendered.  

  Customer response

  09/26/2023

  
  Complaint: ********
  
  I am rejecting this response because: Firstly, the business stating I have two different insurance cards is a lie. She asked if I had dental through my insurance because blue cross blue shield is “tricky” with dental and I said I’m fairly confident that I do. I only have one insurance card. Which then she told me she would figure it out while I’m being seen. I am fully aware of my part in what I signed and take responsibility for not being 100% sure if my insurance was taken by this practice, but never have I ever been to any practice that states they don’t run new patients insurance at all before hand. That is absolutely absurd. The business states in their message they were also aware they were sending me back to been seen without being 100% sure I was covered. You’re telling me that is an honest family oriented company? I would never willingly go to a dentist that was not covered by my insurance and pay hundreds of dollars when I could go to a dentist that does cover me and would let me know otherwise if they didn’t before my appointment. I would expect a dental practice that is so profound would take better care of their new patients and make sure everything was right and covered before telling them to be seen. It doesn’t matter what I signed. That is called integrity and honesty which seems to be lacking at this office. 
  Sincerely,
  
  ******* *******

  Business response

  10/02/2023

  As previously stated, verifying insurance benefits and billing insurance companies is a courtesy, which we gladly do, for our patients.  However, it is ultimately the patient's responsibility to have insight into their particular dental plan.  We did not have benefit information prior to this appointment, therefore, the benefits had to be verified once the patient arrived for their appointment.  The complainant could have declined starting the appointment prior to obtaining benefit information.   In the initial complaint the complainant claimed she gave us insurance information over the phone prior to the appointment, however, in the second complaint she claims she responded "I’m fairly confident that I do" when asked about insurance coverage.  We ARE a family-oriented, honest, and fair office that provides exemplary care and compassion to all of our patients.  Our online reviews, extensive patient base, and absence of any complaints to the BBB confirms our character and integrity.   Finally, it does matter that our HIPAA form which clearly states our financial/insurance policy was signed.  A service was provided and the claimant is responsible to pay for said service.  

  Customer response

  10/02/2023

  
  Complaint: ********
  
  I am rejecting this response because: This company is adding extra adjectives to this story that were never used. This business is attempting to make me look inconsistent with my story when in reality their business practice is wrong and their story is false. This business and or receptionist is grasping at straws to keep adamant that my appointment was handled with respect and honesty, which it wasn’t. Not once did I state the services shouldn’t have been paid for, so the fact that’s their only argument is becoming redundant. My complaint is how they handled the insurance situation and how I was told to go ahead and start the appointment giving me false reassurance that everything would be fine with my insurance. Regarding their very happy patients, they are now losing three that have been with them for years because of their dishonest business practice. 
  Sincerely,
  
  ******* *******

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