ComplaintsforArtisan Smiles

• Initial Complaint

  07/17/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Multiple reps from my insurance company, **** *** ***, have told me that they CONSTANTLY have calls about this provider changing patients when they are 100% covered. Dental code *****, specifically. They are constantly using this code to charge patients when they shouldn't because they know the insurance companies will not pay this code. I worked in billing for insurance and there are multiple codes they could use, but they refuse because they can just get cash from the patient. The insurance companies are well aware of Artisan Smiles, and the surgeon. I have been told the insurance companies are investigating them for their shady billing practices. When I spoke to the lady, *****, in billing, she told me the opposite of what my insurance told me. She told me that the charge was covered for the first surgery but not the second. But on my claim / EOB, it was not covered on the first one. She spoke to me like I was stupid and had no idea what I was talking about. **** *** *** is a common ***************** insurance and the people on it have little to no income. Most services are covered 100%. The surgeon/biller is tacking on charges to the patients. This is not a proper practice.

  Business response

  07/28/2023

  Code ***** is the only code we can submit. We run a prior authorization to insurance companies which is when we submit the narrative. We submit a narrative of medical necessity for each code that is being billed for each clients surgical procedure.   If insurance denies the codes we always tell the PT that they should submit an appeal. When they submit an appeal 90% of the time these insurances cover the code. We can not bill a different code if it is not for the actual service being rendered. 

  When PT called and spoke to our billing manager she was yelling and using a demining tone as we were only trying to assist her with the information on the denial we received from the insurance company. 

  We can provide all documentation and medical necessity narratives if needed.

• Initial Complaint

  04/07/2022

  Complaint Type:

  Billing Issues

  Status:

  Unanswered

  More info

  My braces were first put on in October 2020. My braces and Orthodontist *************************** were paid in full on 12/8/21. Since then the office has called to cancel each monthly appointment (4 months in a row). My mom has left messages and emails but no one has replied. The wire are now loosened because the rubber bands are gone. My mouth hurts and bleeds. We have left messages for dr. Without reply. When the scheduler calls to reschedule each month we are told it is a problem with a building but they don’t have any information, they said they are “sorry but can’t help.” And “ they know this wrong but it is happening to a lot of people.” My mom called another office in York PA. It is over 76 miles from the office I am treated at. We are told we must go there for service but this is very difficult to travel 2 hours in one direction. This office doesn’t even offer extended hours or weekend service to help accommodate travel. They have never sent out information by mail or email explaining why my treatment plans have stopped, just canceling the appointments. Artisan Smiles is fully paid, my parents portion as well as the insurance carrier. If they are unable to continue serving they should return payment so I care received care from another provider. They have created an unrealistic burden to receive care, they have continually canceled appointments extended the length of time I am required to wear braces, they have failed to notify me of the changes of location for treatments. They are withholding payments for services and not providing services. At best this practice is poorly managed at they are knowingly defrauding patience. I would like a refund so I can receive help from another doctor. 

  Customer response

  04/07/2022

  On April 6, 2022 around 9:O0 AM I called the Armore Corporate Office,  I asked if my daugther appointment could be moved up because her mouth was bleeding and she was complaining of pain.  Maria said not only would our appointment for april 27 not be moved but she was told to cancel all appointments for April.  I asked who I can speak with, ***** said this office did not have a dentist there try York PA office.
  
  At 9:22 I called the York PA Artisan Smile office, I asked to speak to the Dentist or a manager , my child needed to be seen urgently.  I was transfer to ******, who said she was the billing manager. She said she was the only manager avaible to answer the phone.  She said  my daugther's doctor could  not be seen on April 6 afternoon, but someone couldjust "cut out the wire" We ended up scheduling for Thursday April 7, 2022 at 4:30 when an actual adjustment could be perofrmed . I also had to arrange travle and child care for my other child.
  
  I asked ****** if it was normal practice to go without treatment for so long, she said she did not know, I asked why we were not told able the "emergency" at the Chester location, in writing . Morgan said "we were told by the phone schedulers"; I said that was not true , we were not given information on where we could continue receiving services or  emgerncy care if needed. We were not given a time frame when or if we could schedule locatally, and were were not provided contact information for the York office.  I had to seach for it in google. She then  claimed to have  recorded all calls.  I asked for the auto files because what she was claiming did not occur. Morgan than dismissed my concerns by saying " I was just rude and she did not have to help at all, she was just beining Nice." 
  
    I asked multi times about scheduling at other locations and if weekend or late nights were available because of the travel distance.  Just as a note their calling system does not say they are recording the calls. 
  
  In my opinion this business is not working in good faith, every interaction since they have been paid in full has been purposely difficult to recieve the services owed to my child.  

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