Complaints

This profile includes complaints for Salem Periodontal Specialists's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Salem Periodontal Specialists

  2605 12th Pl SE Salem, OR 97302-2576

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  Salem Periodontal Specialists

  2605 12th Pl SE Salem, OR 97302

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:01/27/2023

  Type:Sales and Advertising Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I had "pre-authorization" for periodontal procedure. Procedure done : 11/09/2020. Salem Periodontal Specialists (SPS) did not submit claim until 10/12/2021 (1 year later). Then GEHA dental insurance did NOT process the claim until 11/19/2022. During this LONG period, SPS staff advised us MULTIPLE times NOT to worry; we had paid our portion; it was between them and the insurance company. ***************** requested additional info from SPS; they (SPS) did not appear to be able to produce the information; missing x-rays and files. Now SPS has turned the insurance amount ($2,636.66) over to collections. I understand my financial responsibility. But I believe that SPS has NOT conducted themselves in an ethical manner with regards to this account. I am also filing a complaint with the ****** *************

  Business Response

  Date: 02/09/2023

  The patient did not request a pre-authorization to be sent to the insurance.  It is not our policy to send pre-authorizations to the insurance unless requested by the insurance.  The claim was submitted right away, however it was in deed missing an xray that their insurance did require.  We were able to get the xray and resubmit to the insurance.  There was a lot of back in forth with the insurance but our policy as signed by the patient is the balance is ultimately the patient's responsibility regardless of insurance coverage that we bill as a courtesy to our patients. We did our best to work with their insurance even though it was just a free courtesy we offer our patients.  We have finally received insurance payment 1/2023.  Most of the procedures that were completed was not a covered benefit with the insurance.  I had reached out several times to the patient regarding the account balance in which the patient and wife refused to make any payments.  The patient had several dates of treatment that was in deed sent to insurance and paid by insurance but they were not willing to make their patient portion. The patient then threatened us with an attorney regarding the patient balance continuing to bring up the "non covered services" that their insurances deemed and that we did not do our part with the insurance to get these covered when in fact they are just not a benefit of the policy.  I have gone back in forth trying to work with them stating that one of the services that *** have been covered by the insurance that the insurance deemed "not enough clinical evidence" for the procedure to credit them what insurance would have paid.  I offered to also remove all late fees associated with the account that are charges from 2019-2020.  The patient is still not happy and does not want to pay their patient portion at all.  They have made no attempt to pay anything on the account or set up any payment arrangements.  All of this came about after I told them that we needed to collect this past due amount which I have no notes or documents stating that have been in recent contact, or i was going to send them to collections.  Please see all documents attached.  This is just a patient that does not want to pay their bill and is angry with the amount their out of network insurance paid unfortunately.  I have gone above and beyond to work with this patient and resolve the issue including extending the time needed to review the account asking what we can do to help, offer payment plans that is NOT our policy to offer but to help them out.  I have sent multiple emails with them just asking the same questions over and over and bringing up us not having the claim sent correctly the first time.  I feel after 2-3 years of working with the patients on this claim that we have done our due diligence to assist the patient with their insurance company who we are not affiliated with at all.  I have more information if you would like to see it.  

  Customer Answer

  Date: 02/11/2023

   
  Complaint: 18942000
  
  I am rejecting this response because:

  1.  WE DID REQUEST THAT SPS OBTAIN PRE-AUTHORIZATION from the insurance company and were provide a document from SPS that indicated the insurance benefits.  We would NOT have proceeded on such as major procedure without the confirmation; that is WHY we pay insurance premiums;  we would have found a different dental provider!!!
  

  2.  During the "the two years" we were assured numerous times by SPS that everything would be fine; "THEY" were working it out with GEHA and we had "nothing to worry about"!  ... "due to COVID", things were slowed down!
  

   

  
  
  Sincerely,
  
  *************