ComplaintsforEmmert Dental Associates

• Initial Complaint

  07/03/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  April 4, 2024 Would like to know if I had 4 or 5 teeth extracted because the sockets shows 5. Not billing my dental insurance and never sending an actual bill of services rendered while demanding money. Now the FSA is demanding me to pay them back by 8/4 which is 4 months after my services. So a itemized bill and my dental insurance should have been generated or charged by now. Next step will be the dental board

  Business response

  07/09/2024

  BBB of Southwestern Pennsylvania - Pittsburgh Chapter
  

  Complainant ***** *****
  

  To Whom It May Concern:

  
  We are writing in response to a complaint filed by *** ***** *****. The complaint is
  baseless, groundless, and without merit. *** ***** authorized, consented to, and requested all
  treatment. No treatment was done without her expressly signed and written consent. She was
  informed at the onset of her treatment needs and financial responsibility. Signed treatment
  consent forms with signatures attached are enclosed. Financial disclosure statements were
  reviewed by her and signed by her. A signed sales slip specifying the amount due is enclosed. All
  treatment was authorized by *** ****** The signed sales slips, signed financial disclosures,
  signed treatment consent forms, and treatment acknowledgments attest to the validity of the
  treatment and to the knowledge and acceptance of financial responsibility by *** ****** All
  treatment was provided, received, and completed on date-of-service 04/03/2024. *** ***** had
  abscess drainage, extractions, and bone grafting to resolve her dental infections and eliminate
  pain and swelling. She was informed of her financial out-of-pocket expense and proceeded to use
  a form of CareCredit to finance her expense. The CareCredit application filled out by her
  unfortunately was denied. The office extracted her infected, painful teeth, thereby resolving
  infection, despite the fact that *** ***** was not approved for financing nor paid by any other
  means. Upon completion of treatment, *** ***** was fully aware of her financial responsibility
  and out-of-pocket expenses on 04/03/2024. To date, she has never made a payment nor attempted
  to make a payment on her balance. An invoice for the amount due was sent to her on or about
  06/23/2024. Predictably, she made no payment, but, in response, filed a complaint with the BBB.
  The complaint filed by her was in direct retaliation to the invoice she was sent requesting she
  make a payment for dental services provided and completed. Further, the office has made several
  overtures to *** ***** with multiple attempts to resolve this situation amicably prior to
  dissolving into a dispute. These overtures include fee and cost reductions, cost discounts,
  refinancing, and repayment over an extended timeframe. The office invested directly in *** ***** with office expenditures geared to treat her dental needs and resolve her infection. No
  payment has been made to-date. All work authorized by *** ***** was completed but never
  paid for. Now, in response to the bill that was sent directly to her, she complained to the BBB.
  The office completed all work professionally, expertly, and well within the standards of care. At
  this point, Emmert Dental would be within its full legal rights to file a theft-of-services charge
  with the local magistrate.
  
  Thank you,
  M. B**** Emmert Dental Associates

• Initial Complaint

  10/26/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On 11/29/22 I went to emmert dental because a crown previously installed there had become loose and had fallen out. They installed 2 posts (not sure why they needed 2 as ins only covers one),made a new temporary crown and did the moulds for the new crown. Upon leaving the office I was told by the owner Michele that I owed 1575.00 because the crown would not be covered by my ins. I informed her that I still had 364.00 remaining in benefits for 2022 so she deducted it leaving a 1211.00 balance. I paid the balance using my care credit acct. (Receipt attached) I was told I'd be notified when the new crown arrived so I could schedule an appt. To have it installed. I was informed a couple weeks later thar the new crown came in but was poor quality so it was sent back and a new one was ordered. The crown finally came in late Dec. And an appt was scheduled for 1/7/23. On 1/7/23 I went in and they removed the temp crown and cemented in the new crown. No other procedures were performed that day other then installing the new crown. After this I started thinking why I was charged on 11/29/22 1575.00 and I reached out to Delta dental who informed me that the crown would and should have been covered. I also found out the they filed a claim for a 2971(additional procedures to make a crown fit under a partial denture framework) this procedure was not performed as I have no partials at all. Also I found out that a **** (4 surface amalgam filling was billed for the same tooth number 14 on 1/7/23 which is the same day they installed a crown on tooth 14. After learning the crown should have been covered I reached out to Michele to try and get her to file a claim for the crown and she claimed to want to resolve the issue but never followed through . Finally after 8-9 months of back and forth with her and several delta dental grievances she finally filed a claim for a ****(crown) on 8/11/23. That claim was paid by delta dental on 10/13/23 . The amounts I owed for the 11/29/22 claims were 446.75 and the amounts for the 1/7/23 claims were 30 and 163.75. So I owed 640.50. And paid 1211.00 leaving a balance of 569.50 owed back to me. I asked her when I would expect to see a refund and no response . Then a week later she filed a duplicate claim for the crown with a different dentist that didn't do the procedure and filed it out of network. When I saw that the previous claim was rescinded and now I was being charged an additional 1497.00 for out of network services I called delta and was informed that Michele had contacted them and said that my procedure was somehow now out of network and that they were out of network since 1/7/23. That is totally false . It is my opinion that she does not want to refund me and is playing these games in hopes I give up and let this go. I've talked to her,texted her. Filed multiple grievances on this and there was never a mention from Michele,emmert dental, or delta dental about any issues with wether it was in or out of network. The date to which emmert is supposedly out of network is very interesting as it happens to be the same day the service was done 10 months ago. This dental office is billing people for things ins should be billed for and also billing for things it did not do and also lying that they are out of network to avoid refunding people/stalling the process long enough for people to give up or statute of limitations to run out. There's many reviews of this dental office talking about similar issues that have been going on for years and I hope you can help stop this from happening to me and all people going forward.

  Business response

  02/05/2024

  We are writing in response to a complaint filed by a *** ***** ******** Let me start by
  saying that the allegations are baseless, groundless, and without merit. The genesis of the
  complaint is financial in nature, but we at Emmert Dental Associates are more than happy to
  address any concerns expressed by *** *******, and invite the Better Business Bureau to review
  the quality of the treatment, the billing process, patience experience, or co-insurance
  calculations. *** ******* authorized, requested, and consented to all treatment. No treatment was
  performed without his expressly written and signed consent. He was informed at the outset of his
  treatment needs and financial responsibility. Signed treatment consent forms with signatures
  attached are enclosed. Financial disclosure statements specifying out-of-pocket expenses and
  financial responsibility were reviewed by *** ******* and signed by him. All treatment was
  authorized and requested by *** *******. The provided treatment was initiated on an emergent,
  immediate basis to alleviate acute pain and discomfort as described by *** ******* on his initial
  visit dated 11/29/2022. He requested urgent treatment to relieve pain, swelling, and discomfort
  associated with broken, decayed, and deteriorated tooth #14.

  During the treatment process, every effort was made in an immediate manner to relieve
  pain, restore function, remove structural decay, resolve infection, and revitalize his broken tooth.
  The complaint focuses solely on financial out-of-pocket expenses, as most complaints always do.
  *** ******* was financially counseled regarding financial responsibilities, financial obligations,
  co-insurance, and co-payments at the initiation of treatment. The financial aspects of the
  treatment were broached with *** ******* and directly discussed with him by the front desk staff
  and business finance managers. Financial responsibilities are always the primary topic
  immediately open for discussion prior to any treatment. This clarifies patient’s co-payments and
  co-insurances, providing a lucid understanding of financial obligations and patient expenses for
  treatment. A consent and co-payment estimation was presented to *** *******, requiring his
  signature to demonstrate payment awareness and secure his financial authorization. A notation
  was made in his dental record indicating patient financial consent and patient-payment
  acknowledgment. *** ******* requests a refund for provided services. No refund is due from our
  perspective. We adamantly dispute and contest any assertion that a refund is due or that an
  overpayment was made. Treatment was initiated on 11/29/2022 (approximately one year ago) by
  Dr. Roberto M********* Dr. M******** initiated, performed, and completed all necessary
  procedures to repair and restore the complainant’s broken tooth. *** ******* authorized,
  requested, and consented to treatment with Dr. M********* It bears repeating that the complainant
  authorized, requested, and consented to all treatment with Dr. M********* Signed dental treatment
  consent forms with signatures attached are enclosed and bear both the signatures of *** *******
  and Dr. M********* The enclosed signed dental treatment informed consents, signed financial
  statements, and signed treatment acknowledgments attest to the validity of the treatment, the
  cost, and *** *******’s awareness of the treating provider. *** ******* implies that a Dr. C********
  (an associate dentist in the practice) treated him, but that is incorrect. This is an attempt by the
  complainant to mislead and misrepresent the facts of this case. All treatment was provided and
  completed by Dr. M******** with full authorization by the complainant. Treatment was initiated
  on 11/29/2022 by only Dr. M********* This included and involved dental services to restore
  broken tooth #14 and included:

  1. ***** – Post-Placement
  2. ***** – Second Post-Placement for Added Support and Tooth Stability
  3. ***** – Crown Elongation to Increase Structural Support and Surface Area for
  Retention
  4. ***** – Crown Preparation with Impression for New Permanent Crown
  5. ***** – Temporary Crown Placement for Healing

  
  *** ******* questioned code ****** which is a valid code used to report placement of a
  temporary crown following crown elongation and crown preparation, requiring a period of both
  (soft) gingival tissue healing and (hard) tissue healing prior to delivery of the permanent crown.
  A second date-of-service, 12/5/2022, was utilized to assess the healing phase post-operatively
  and to adjust the complainant’s bite to reduce heavy occlusal bite forces which could delay
  healing. The final recorded date-of-service, 01/07/2023, accounted for placement of the
  permanent crown by Dr. M********* At that appointment, an additional foundation filling (code
  *****) was placed to augment tooth structural support and make tooth #14 more receptive to
  crown placement. The reported code (as questioned by *** *******) was *****, but the insurance
  company (Delta Dental) amended the ***** code and replaced ***** with *****. The office
  had no control over that code relabeling. The code change was done solely at the discretion of
  Delta Dental. Upon treatment completion, all the appropriate insurance claims were sent to Delta
  Dental. As required by the office’s provider agreement with Delta Dental, the treating provider –
  that is, the dentist who provided the care and performed the dental work (Dr. M********, in this
  case) – is to be listed as the treating dentist on the submitted dental insurance claim. The treating
  provider is always, per Delta Dental insurance guidelines, the billing provider. As a result, in an
  effort to be compliant with provider agreement guidelines and insurance regulations,

  Dr.M******** was reported and listed on the appropriate insurance claims as both the treating

  provider and billing provider. Dr. M******** as the treating provider, is ultimately and decisively
  the billing provider, and this fact cannot be changed. To remove or change the billing provider on
  the claim form is both deceptive and fraudulent. To do so could potentially be regarded as a form
  of misrepresentation. All claims were promptly submitted with Dr. M******** as the treating and
  billing provider. Upon claim receipt, Delta Dental, for unknown reasons or for reasons only
  known to Delta Dental, would not recognize Dr. M******** as a billing provider. The insurance
  claims were submitted initially but denied by Delta Dental. Unaware that there was a billing
  provider concern, the office resubmitted the claims, which were denied a second time, not
  surprisingly. At that point, the office attempted to re-verify the information on file with Delta
  Dental and promptly resubmitted the claims (third time) in an effort to achieve claim reversal on
  behalf of *** *******. But that attempt at reprocessing proved to be an exercise in futility as the
  benefit determination would not be changed. The office worked earnestly to obtain a claim
  reversal for the benefit of *** *******. All the appropriate insurance claims were submitted,
  resubmitted, and submitted a third time, despite *** *******’s insinuations to the contrary. The
  claims were submitted with Dr. M******** as both billing provider and treating dentist because he
  was. Upon the second claim denial, the office inquired as to the processing delay and as
  mentioned, re-verified the appropriate provider information, and submitted all claims for
  reprocessing. Again, this cycle was denied by Delta Dental. Delta refused to claim process with
  Dr. M******** as the billing provider. Dr. M******** was labeled as “non-participating” with
  Delta and as such, those claims with Dr. M******** as the billing provider were impermissible.
  The office proceeded to verify the accuracy of the claim information with Delta by ensuring that
  the billing providers’:

  1. TIN
  2. NPI
  3. Practice Location – PL
  4. Licensing Number
  were registered with Delta Dental. New claims were generated and submitted, but met with
  denial. This cycle of re-verification with resubmission was done repeatedly to obtain claim
  benefits on behalf of *** *******, but Delta refused to grant claim acceptance. *** *******
  indicates that he was treated by Dr. C******** (practice associate) but that is inaccurate. Dr.
  C******** never treated *** *******. For *** ******* to say that Dr. C******** treated him, in any
  capacity, is an outright falsehood with intent to mislead. In fact, to promote any other dentist than
  Dr. M******** as the treating dentist is an egregious act of misrepresentation. But, it is apparent
  that *** ******* is willing to blatantly misrepresent the treating provider in an attempt to falsely
  and deceptively obtain improper insurance benefits. This office, Emmert Dental Associates,
  cannot and will not be party to that. Further, it would be a form of insurance misappropriation
  regarding claim processing guidelines to list a non-treating provider as the billing provider,
  directly causing a contractual violation of insurance provider-insurance carrier agreements. A
  violation of said contractual provider agreements lends itself to certain monetary penalties and

  potential provider exclusions. The office will not place itself in this position, despite complainant
  *******’s false, inaccurate, and misleading assertions.
  Now, regardless of the provider, whether it be treating provider or billing provider or
  otherwise, *** ******* did not overpay. No refund is due *** *******. The following co-payment
  and co-insurance calculations confirm that. *** *******’s co-insurance was determined by
  applying the plan’s co-insurance percentage to the insurance stipulated, usual, customary,
  reasonable allowable fees for provided services. The appropriate percentages were determined
  and applied to the appropriate allowables, as outlined and indicated in the description of benefits
  and co-payments within the Delta Dental Office Allowable Guide. *** ******* indicated, in his
  complaint, that he had a secondary insurance carrier. At the time of service, the office had no
  record of a second carrier. Office calculations determined *** *******’s out-of-pocket expense for
  all services to be $1304.50. The provided services included:

  1. ***** * Limited Examination
  2. ***** – X-Ray #14
  3* ***** – Second X-Ray #14
  4. ***** – Post-Placement
  5. ***** – Additional Post-Placement
  6* ***** – Crown Elongation
  7* ***** – Temporary Crown Placement
  8. ***** – Occlusal Adjustment
  9. ***** * New Crown Placement
  10. ***** * Crown Insert and Delivery

  Total Cost of Treatment – $1304.50.
  This cost is correct and irrefutable as indicated by the following information. The new
  crown on tooth #14, as prepared and delivered by Dr. M********, was denied by Delta Dental, as
  a result of frequency. Apparently, that particular crown was less than five years old and Delta
  Dental would not cover placement of a new crown prior to that five years. *** *******’s
  out-of-pocket expense for that crown amounted to $446.75. The first post-placement in that same
  tooth carried with it a cost of $97.50. *** ******* was responsible for 50% of that cost, which
  amounted to $48.75. A second post-placement was necessary for tooth stability and was placed
  by Dr. M********, but that second post-placement was denied by Delta Dental. For that second
  post-placement, *** ******* had a financial liability of $398.00. Crown elongation was necessary
  to restore tooth #14, but that service was denied, as well, by Delta Dental. *** ******* had an
  out-of-pocket expense of $411.00 for that service. Based on our calculations, *** *******’s total
  out-of-pocket expense for treatment of tooth #14 was $1304.50. *** ******* paid $1202.00. Our
  records indicate that *** ******* owes the difference – $102.50. Based on the above information,
  and given the fact that *** ******* paid $1202.00, it stands to reason that *** ******* has an
  outstanding, past-due balance of $102.50. There was no overpayment. There is no refund due
  *** *******. The outstanding past-due balance is confirmed by the enclosed Delta Dental
  explanations of benefits.

  *** ******* indicates in his complaint that the office filed four separate insurance claims.
  That is correct, *** ******* had multiple dental services performed on different dates-of-service,
  generating multiple insurance claims. Not all dental services are added to the same dental claims.
  For example, periodontal treatment is distinct and separate from crown placement, with distinctly
  different coding, requiring distinctly different attachments and distinctly different explanations,
  thereby, requiring separate and distinct claim forms and submissions. Each service has a
  distinctly different set of claim filing and submission requirements that frequently require
  individualized, categoric filing. In other words, all feet don’t wear the same shoe.
  There was no negligence nor impropriety regarding treatment, the treating provider, the
  office, nor the practice of the profession. Treatment was provided to *** ******* in the most
  appropriate and professional manner with financial responsibility managed with the utmost
  professional and ethical standards. That, in and of itself, makes this complaint unsubstantiated.
  The office is certainly not in breach of any provider agreements, participating or otherwise. The
  office fulfilled its obligations to complainant *******, regarding provider participation and
  provider conduct by:

  1. Obtaining informed consent for treatment
  2. Obtaining informed financial consent for treatment
  3. Calculating co-insurance appropriately
  4. Prompt claim submission with appropriate coding followed by resubmission,
  upon recognition that claims were unprocessed
  5. Inquiring with Delta Dental to rectify unprocessed claims on behalf of
  complainant *******

  We, at Emmert Dental Associates, firmly believe that in an attempt to secure monetary
  gain, *** ******* deliberately attempted to mislead the Office of the Attorney General by
  indicating that he was treated by a provider other than Dr. M********* He is using the Office of
  the Attorney General as a tool to deceptively obtain a refund for which he is not owed nor
  deserve. The enclosed Yelp review, written by *** *******, in which he disparages and belittles
  the office clearly demonstrates his acknowledgment that Dr. M******** treated him. According to
  the Yelp review posted by *** ******* on April 6th, 2023, he stated, and I quote, “I had some
  work done in November of 2022 by a dentist by the name of ******** [sic].” That statement
  made by complainant *******, in and of itself, devalues this complaint. To be clear, the office sees
  and treats 180 patients per week, and over 550 patients per month. The portion of negative
  comments is less than 1% of the total patients seen. Negative comments are easy to make on the
  part of the complainant but are damaging to the reputation of a wholesome neighborhood dental
  practice that has been in business for over 40 years with thousands of happy, smiling, returning
  patients. It is not the happy patients that spew inaccuracies, hate, and vitriol, but the singular
  dissatisfied patient that attempts to cast aspersions on the practice’s impeccable reputation. The
  office made multiple attempts to achieve claims payment on behalf of *** *******, despite his
  animosity towards the practice. As a courtesy to *** *******, and in an attempt to resolve this
  complaint, we at Emmert Dental are more than happy to disregard the outstanding balance of
  $102.50 and zero balance the account. With the account balance adjusted to zero, we now
  consider this complaint closed and resolved.
  

  Thank you,
  M. B***, Manager
  Emmert Dental Associates

  Customer response

  02/08/2024

  I'm writing in response to Emmert Dental's response to my complaint dated 02/05/2024. I'm going to start by saying that although Emmert claims my complaint is baseless, groundless and without merit. I will prove that is false and an attempt at playing the victim and pointing blame for their deceptive, deceitful and fallacious billing practices onto the actual victim in this case. Emmert's assertion that this is merely financial in nature is true in part but there's much more to this than money. This case is about going in to Emmert Dental on 11-29-22 because of a previous crown Emmert Dental had done the preparations for on 10-19-2017 and installed on 11-02-2017 (see figure 1).

  Emmert claims they gave me some sort of estimate prior to treatment that day which is a total lie. The form submitted to you by Emmert is a complete fabrication. (see figure 2). The form has been created from a previous consent form and I invite Emmert to produce the original signed copy for review. Next, we have a treatment consent form (see figure 3) that has obvious changes made to it including the date and work to be done. There is obvious differences with the initials two of which being definitely mine and two of which being clearly written by someone else. It is my belief that this form was changed from a previous treatment consent form dated 4/10/2021 when I had a bridge done by Emmert Dental. Again, I invite Emmert to produce an original signed copy for review. There is another treatment consent form that Emmert provided to you as well. (see figure 4) This form also has 2 different types of initials on it as well and it makes no sense to submit 2 separate treatment consent forms for the same date of service that say the same things. 

  
  Treatment was provided by Roberto M******** on 11-29-2022 to repair a crown that had become loose and fallen out. The treatment consisted of installing 2 posts (dental codes ***** ****) crown elongation ****** **** (additional procedures to make a crown fit under a partial denture framework) which I have disputed from the beginning as an add on that wasn't performed. There was also a temp crown installed that day but never billed for. These claims were submitted originally to Delta Dental with Roberto M******** as the provider. Delta Dental denied these claims multiple times stating that Roberto M******** was not registered as being part of Emmert Dentals group. After many attempts by Emmert Dental to get payment on these claims using Roberto M******** as the provider were unsuccessful, they then changed the provider on these claims to get the claims paid using Emmert associates inc. and Steven C******** as the 
  the 11/29/22 date of service and DR12 for the 01/07/23 date of service as well as proof of providers being changed to Emmert associates inc. and Steven C********. (See figure 5). Ultimately this claim was paid using Steven C******** as the provider. There is no dispute here as to whether this treatment was authorized except the 2971 which was not listed as a service provided on 11-29-2022 in Emmert's own records as indicated in figures 5 and 6. Upon completion of the above referenced procedures I was told on my way out that I owed 1575.00. Despite Emmert's claims that an estimate of 1202.00 was provided to me before treatment this is a lie intended to establish, I knew somehow there would be significant costs related to these services. After being told by Michele B*** I owed 1575.00 I asked her to explain the reasons for this charge. I was informed that the crown would not be covered due to a Delta Dental policy of only paying for a crown on a specific tooth once every 5 years. This is false because the previous crown was prepped for on 10-19-17 and installed on 11-02-17 which would put that previous crown on tooth 14 over 5 years as the new crown on 14 was prepped for on 11-29-22 and installed on 1-7-23 as per figures 1 and 6. Subsequently Michele B*** asked me to pay a balance of 1575.00 and I informed her that I had 364.00 remaining of my 1000.00 total benefit in my Delta Dental plan. She then deducted the 364.00 from my balance of 1575.00 which left a balance of 1211.00. I paid 1211.00 with my care credit acct. on 11-29- 22 before leaving the office. (See figure 7). After leaving I was thinking about what I was billed, and it didn't add up. I thought it was strange that if I owed 1575.00 due to a frequency limitation for a crown on tooth 14 then why did Michele B*** deduct the 364.00 in remaining benefits in my delta dental plan from my balance. In other words, if my ins didn't cover the crown it wasn't going to give Emmert the 364.00 she deducted from my balance. With this in my mind I decided to call Delta Dental to ask if there really was a frequency limitation that prevented them from paying for the crown. I was informed that that was not the case and that if Emmert had submitted a claim it would have been covered. The **** or temporary crown was never billed to Delta dental because a temporary crown is considered part of the permanent crown procedure and not billable separately to the patient as per Delta Dental dentist handbook (see figure 8). Since I had been billed out of pocket for the crown on 11-29-22 the **** temporary crown could not be billed to Delta separately without a claim for a crown. I pleaded with Michele B*** to file a claim for the crown ****** for months as I knew being billed out of pocket for it was in error. Finally, she filed claims for the crown in August of 2023 almost 9 months after my initial date of service. 
  Upon leaving on 11-29-22 I made an appt. for the placement of the permanent crown a couple weeks later which was canceled by Emmert after they had examined the permanent crown when it came in and determined it to be of poor quality, so they ordered a new one to be made by their vendor. The new crown came in late December and an appt. was set for 1-7-23. On this date of service, I saw Dr. C******** for the removal of my temporary crown and the installation of my permanent crown. I have never implied that Dr. C******** treated me on 11-29-22 but I was treated by Dr. C******** on 1-7-23. DR. M******** DID NOT PLACE THE PERMANENT CROWN OR ANY OTHER PROCEDURE ON 1-7-23! All claims filed by Emmert for 1- 7-23 for: 
  *****-limited oral evaluation 
  *****-intraoral periapical first radiographic image 
  *****-resin based composite-four or more surfaces. (changed to *****) by Delta Dental. 
  All have Dr. C******** as the provider (see figure 9). Y Note the crown has still not been billed for since I paid out of pocket for it on 11-29-22. Emmert wants you to somehow believe that the permanent crown was done by a different dentist on 1-7-23 than the 3 other procedures performed on the same date. note Dr. C********'s provider reference number is ****. As previously shown in figure 5 Dr. M********'s is ***** 
  NOTE: all claims for services rendered 11-29-22 were filed using M******** first as the provider then Emmert associates inc. and eventually submitted using Dr. C******** ****** As the provider as noted in figure 5,6. 
  I have never questioned D**** as it was never billed for or mentioned because it was part of the overall crown service and not a separate billable service to the patient as shown in figure 8. However, I have disputed and still do dispute the use of ***** which Emmert has filed claims for and doesn't even mention in its list of procedures on page 4 of its response. ***** is an inappropriate dental code for what was done on 11-29-22. All services provided on 12-05-22 including: 
  *****-limited oral evaluation 
  *****-intraoral periapical first radiographic image 
  *****-occlusal adjustment 
  Were billed to Delta Dental using Dr. C******** as the provider despite Emmert's assertion on page 7 of its response that Dr. M******** was the provider of these services. Let me be clear only the services rendered on 11-29-22 were performed by Roberto M********. Any claim otherwise is a total lie and a further attempt at discrediting me. 
  As for the dental code ***** - CORE BUILD-UP. This would have been done as part of the post and core procedure ****** on 11-29-22 and is not billable separately to the patient as per Delta Dentals dentist handbook (figure 10) This code was never used when filing claims with Delta Dental ever. The code originally used by Emmert was ***** (resin-based composite 4 or more surfaces) in a claim for the 1-7- 23 date of service and was changed to a ***** (amalgam four or more surfaces) by Delta Dental (figure 11). So Emmert mentions nothing about **** anywhere in its own records. The first time **** is mentioned is in it response to my complaint on page 7. There have been no claims ever filed using code ****. However, Emmert did file a claim with ***** that was changed to *****. No matter which one of these codes were used it would have been done prior to the impression for the permanent crown being done. This means this was done on 11-29-22 not 1-7-23 and it also should not have been billed separately as it was part of another service. Emmert Dental has shown a pattern of unbundling. Unbundling is a practice of submitting separate claims for services or procedures that should be billed as a single service. This practice is a serious violation of ethical and legal standards and is usually done for financial gain as it results in overcharging the insurance co. Emmert has also altered many claim forms with multiple providers as well as dental codes. Information was changed several times to receive payment from Delta Dental. This practice often leads to mistakes being made and can also lead to inaccurate claims processing and may cause insurance companies to refuse to pay all together. I also believe that there was some billing for services not rendered with ***** as well as *****. There may also be an element of upcoding going on here as well which is a practice of using an inaccurate billing code to obtain a higher reimbursement from the insurance company. 
  Emmert Dental on page 4 of its response mentions nothing of *****, ***** OR ***** in its list of services provided and doesn't use any of these in its calculations on same page. I contend that these codes were either part of another service or attempts at billing for services not rendered. Emmert claims on the bottom of page 2 of its response that as per the provider agreement with Delta Dental they must use the 
  dentist who performed the procedure as the treating provider on the claims. They have stated what is supposed to happen, but I have shown evidence that Emmert had changed providers on claims multiple times. In figure 5 it shows Roberto M******** as the provider on Emmert's own office computer screen then claims submitted using Emmert associates inc. and Steven C******** as treating providers. Emmert admits that changing providers is deceptive and fraudulent. Emmert also claims it had no idea why Delta Dental would not recognize Roberto M******** as the provider on the 11-29-22 and that is also false. I talked to Delta Dental many times concerning this issue and the issue was always according to Delta Dental Roberto M******** was not registered as being part of the practice and that he needed to be added to the practice and his tax id updated. They also needed x-rays related to procedures to process claims. This was relayed to Emmert on multiple occasions. I was told by Michele B*** that it was a formality, and it would be fixed and not to worry about it. Apparently, the issue was never fixed, and they then decided to change the provider's name to gain payment for claims made for service date of 11-29-22. Emmert Has shown in its own response that they made fraudulent claims. They say Roberto M******** was dentist that performed the work then they say Delta refused to accept Roberto M******** as the provider and then eventually change the treating provider to Emmert associates inc. and then Steven C******** to get Delta to pay the claims. At the time of service on 11-29-22 Roberto M******** was an in-network provider for Delta Dental and there's more to this claim that Delta just wouldn't accept him as the provider, and I believe Emmert knows the reason but doesn't want to voluntarily disclose it. 
  On page 3 of Emmert's response they claim they are going great lengths to help me but in fact it was deception in the initial out of pocket charge from day one that started this ball rolling. It was a lie that the crown wouldn't be covered by a 5-year frequency limitation. Michele B*** even tells me this in a text message that I've attached but it's false. I do agree that such a policy exists to put my previous crown on tooth 14 was over 5 years prior to 11-29-22 as shown in figure 1. They go on to tell another lie that I was never treated by Steven C******** which I was completely shocked to read. Steven C******** is the treating provider in just about every claim filed with delta dental for my dental care and is also not just an associate dentist he is the primary dentist and owner of Emmert Dental. So, are they suggesting they submitted all those claims fraudulently? But it gets even better as they say I'm willing to blatantly misrepresent the treating provider to falsely and deceptively obtain improper insurance benefits. This is exactly what they have shown themselves doing with their own response. They have listed non-treating providers as billing providers on all the 11-29-22 claims stating that Roberto M******** was treating provider but they couldn't get the claims paid so they switched the treating provider twice and are trying to say C******** never treated me but he's the treating provider and billing provider for not only the claims on 11-29-22 which the records as well as Emmert's comments in its response show M******** as the treating provider for that service date but also on all claims on 12-05-22 and 1-7-23 except one claim that they falsely claim Roberto M******** did my crown on 1-7-23. As I stated previously in all of my 3 grievances with Delta Dental, my BBB complaint from October 23, this complaint as well as my yelp complaint that Roberto M******** only treated me on 11-29-22. 
  This yelp review seems to be misrepresented by Emmert as it claims I have implied somehow that M******** was not the dentist that treated me on 11-29-22. This is false as I have never stated otherwise in any of my complaints or reviews as it pertains to 11-29-22. I must wonder what Michele B*** was reading in that yelp review or my complaint that stated in any way shape or form that Roberto M******** was not the treating provider on 11-29-22. I have attached a copy of the yelp review for you. As I have said previously, I was told the crown wasn't covered due to a frequency limitation that was false. I was charged 
  1575.00 that was reduced to 1211.00 due to a deduction of 364.00 for remaining insurance coverage for year 2022. I then pleaded with Emmert to file claims for the crown after I found out the previous crown was done over 5 years prior as shown in figure 1 and that Delta would pay a claim for a crown if a claim was submitted. Claims for a ***** were not submitted to Delta Dental till 9 months later after the date of service because of my persistence in telling Emmert that the out-of-pocket billing for the crown was in error. They submitted multiple claims for the crown (*****) with different treating providers see figure 12. First claim was filed with Emmert associates as the provider than Steven C******** which was being paid by Delta Dental until they rescinded that payment due to another claim being submitted with Roberto M******** as the provider which was denied because conveniently, they say he was out of network starting 1-7-23 which happens to be the same day as the date of service. As stated, before several times Roberto M******** was not the treating dentist on 1-7-23. 
  Page 4 of Emmert's response indicates that filing claims using the wrong providers is a violation of contractual agreements and lends itself to certain monetary penalties and potential provider exclusions. They go on to say that their office will not place itself in that position. My question is if that's the case why did Emmert do that very thing by changing the providers to gain payment from Delta? They have proven with their own statements and records that my assertions as they call them are completely true and accurate and that the only misleading assertions are from Emmert Dental. 
  Emmert Dental was notified of the secondary ins at the 1-7-23 date of service before services were rendered but never filed claims to my secondary ins which is the same company Delta Dental and has a higher level of coverage then my primary coverage. Emmert eventually filed claims to my secondary ins but kept failing to provide the proper information for claims to be processed. 
  Also, on page 4 of the response they start the bottom paragraph by stating the cost is "irrefutable" as indicated by the following information: 
  1-crown was prepared and delivered and delivered by Dr. M********. This is false in part. I do acknowledge M******** prepared the crown on 11-29-22 but irrefutably did not deliver the crown and or install the crown on 1-7-23. Claim was denied since he was no longer in network as of 1-7-23 but C******** was the treating dentist on 1-7-23 as shown on all the claims submitted for 3 other services provided by C******** on that date of service. The claim was not denied due to frequency. This is also a complete lie and is not referenced by delta in any way as a reason for denial of any claim besides I have shown this frequency claim to be false with irrefutable evidence. 
  2-the 446.75 amount I agree was owed for the additional post 398.00 and my portion of the post and core 48.75 (figure 14) This figure was used twice on page 7 of Emmert's response to my Attorney's General complaint. There is no claims that say 446.75 is owed for a crown The 446.75 figure was added in twice to try and get close to the fictitious estimate of 1202.00 that was never given due to this being an emergency and them having no idea what was necessary till I was already in the chair. 
  3- crown elongation was denied by Delta Dental because its not billable separately to the patient and is considered part of the overall crown procedure. The 411.00 amount in the figure on page 7 of Emmert's response is not owed. (figure 13). 
  4- the amount paid was not 1202.00. it was 1211.00 as shown in figure 7. The 1202.00 like previously stated is a fabrication that is designed to get close to what I ended up paying which was 1211.00 but remember the initial balance I was given was 1575.00 and after I mentioned I had 364.00 left in available benefits for 2022 the 364.00 was deducted leaving a 1211.00 balance. Theres nothing in Emmert's calculations that account for that. 
  5-the 398.00 figure is already included in the 446.75 figure. (figure 14) 
  6- Delta was in process to pay 491.25 for the ***** leaving a balance of 163.75 owed by me the crown **** 
  but reversed that decision when they received a new claim with the wrong provider that was out of network as per figure 12. 
  I owed 446.75 for 50% of the post and core and additional post (****** *****) 163.75 for my portion of the crown (*****) 48.00 for occlusal adjustment 12-05-22 (*****) 30.00 for amalgam 4 surfaces or more ******* for a total of 688.50 and I paid 1211.00 leaving an overpayment of 522.50 and Delta Dental later voided the **** making my overpayment 552.50. 
  Page 5 of Emmert's response states that I claim they filed 4 separate claims and goes on to say that this is because of multiple procedures on multiple service dates. I'm certainly aware that there will be multiple claims for different procedures on different service dates. What I refer to in my complaint is 4 separate claims for the exact same procedure on the same service date using a different provider every time. It insults me that Emmert would explain my concerns about separate claims for identical procedures and service dates away in such a manner as to suggest I'm not aware how the claims process works. Emmert is correct by stating there was no impropriety or negligence regarding my treatment. I believe the Dentists there are qualified and provide great dental care. I don't feel that way with regards to the office or its very deceptive and unprofessional handling of my billing and claims. I was billed out of pocket for a crown my ins would have and should have paid most of and my secondary should have picked up the rest but wasn't even billed for. There were procedures billed for that were not performed ***** and *****/D**** which were both voided by Delta Dental after already paying them months prior. On 1-7-23 I was there for about 20 minutes. Temp crown was removed, and new crown cemented in and that's it other than checking my bite. They also say they treated me in the most appropriate and professional manner which is true in part. Like I said previously the treatment itself was done in an appropriate and professional manner, but the customer service was horrendous after the treatment with false claim of frequency limitation by Delta for crown and over a year going by and still no resolution to this nightmare. I have spent countless hours calling Emmert, visiting Emmert's office, calling Delta Dental countless times and being on hold with them for hours multiple times, filing multiple grievances with Delta Dental, writing several reviews warning people, filing a BBB complaint, an Attorney General complaint and this rather lengthy response to Emmert's farce of a response to my complaint. TO SUGGEST ALL OF THIS TIME AND EFFORT IS TO SECURE MONETARY GAIN OF 552.50 IS DOWNRIGHT LUNACY. 552.50 IS IN NO WAY WORTH MY TIME SPENT AWAY FROM MY WIFE, KIDS, LIFE, HOBBIES AND FRIENDS DEALING WITH MICHELE B***S INABILITY TO ADMIT FAULT IN THIS MATTER DUE TO HER UNWAVERING NARCISSISM. My wife and I both have great jobs and do very well and could care less about the money. This case is about right and wrong and holding Emmert responsible for its fraudulent billing practices that I BELIEVE ARE AN ATTEMPT AT SECURING MONETARY GAIN. 
  There has been no attempt of any kind to mislead the Attorney General about which provider was seen on what day. I have been consistent in that I saw Roberto M******** on 11-29-22 and that was the only time I saw him. To suggest otherwise is false. All the claims for 12-05-22 and 1-7-23 are all with Dr. C******** as the provider with exception to Emmert's false claim for crown on 1-7-23 with Roberto M******** as the treating provider. This is again false. I even had a conversation with Steven C******** on 1-7-23 about how he thought Roberto M******** did a great job on 11-29-22 on tooth 14 and that he reviewed Roberto M********'s notes regarding the challenges he faced with my situation with tooth 14 and given the circumstances he thought it turned out well. Perhaps one day we can hear from Roberto M********, Steven C******** and Michele B*** in a setting that comes with the penalty of perjury and see who's willing to double down with these lies. Here we go again with this yelp review. I don't think Michele read it or just thinks it says something it doesn't. My Yelp review in no way says that Roberto M******** never treated me. In fact, it says Roberto M******** treated me on November 22 (11-29-22). Emmert makes an outlandish assertion that this statement in and of itself devalues this complaint. The problem with that assertion is that I also say in my complaint as well as this response that I was treated by Roberto M******** on 11-29-22. I do, however, dispute Emmert's claim that I saw Roberto M******** on 1-7-23 as that is false. It doesn't matter how many patients you treat per day, month or year. They all need to be billed properly and claims filed properly. Emmert states its negative comments make up less than 1%. that's people who say something publicly and don't account for all negative experiences. Even at 1%, that's 2 patients per day and 5.5 per month that make negative comments. I've seen a lot of comments on various review sites as well as the BBB and just about everyone is a negative comment and most complaints are about deceptive and fraudulent billing practices. Maybe if you're concerned about your reputation you might start by not billing out of pocket for covered procedures and not changing claims to gain payment from an ins co. Emmert Dentals assertion that they are a wholesome neighborhood dental practice is laughable. The word wholesome should never be used to describe this practice. Although I feel the dentists themselves are exemplary and strive to provide top notch care, one bad apple spoils the bunch and that's the office GM Michele B***. 
  In closing it gave me no pleasure to spend a large portion of my day having to refute the many ridiculous 
  Aspersions cast about my character, integrity, morality and my ethics. I have spent many days stressing about this and countless hours dealing with this. My complaint to the Attorneys General is not rooted in any monetary gain whatsoever but rather a yearning for acknowledgement by Emmert that they made mistakes in this case which led to where we are now. I would have loved to not have been lied to about a frequency limitation that was assumed and not verified for my crown that kicked this all off but that's not what happened, and I hope we can resolve this amicably without further action being taken. 
  Thank you, 
  ***** ******* 
  In addition, Delta Dental has voided the *****(additional procedures to customize a crown to fit under a partial denture framework figure 16) because it was not an appropriate code. The code should have been D**** but D**** is part of the ***** procedure code and not billable separately. Procedure code ***** with service date of 01/07/23 has also been voided by Delta Dental (figure 1. Emmert's records indicate that a ***** (core build-up) was done 01/07/23. This service would have been done on 11/29/22 as part of the post and core procedure but was billed as a ***** (resin-based 4 surface filling) with a service date of 01/07/23. Delta Dental changed it to a ***** (4 surface amalgam filling) as a substitute for the *****. At the time Delta was billed for the ***** it had no idea a new crown was ever made on 01/07/23 since a claim for a crown was never filed due to Emmert billing me out of pocket for the crown on 11/29/22. A claim for a crown (*****) was not filed with Delta Dental till August 23 due to my persistence. 
  Emmert has billed me out of pocket for a crown under a false claim of a 5-year frequency limitation. proven to be false. `Previous crown on tooth 14 was over 5 years old based on records Emmert provided me themselves. Emmert has billed for services it did not render such as ***** and ***** both of which were part of other services that shouldn't be billed separately or have been substituted for ser vices that were part of other procedures. Emmert has also billed for several procedures such as crown elongation/lengthening separately when that is part of the overall crown procedure and is not billable to the patient separately as well. Emmert has also submitted multiple claims for the same service on the same dates of service using several different providers including Steven Ernest C********, Roberto Cl***** M******** and Emmert associates inc. 
  

  
  

  Business response

  02/13/2024

  We are writing in response to a complaint filed by a *** ***** *******. Again, let me start
  by saying that his complaints are baseless, groundless, and without merit. The genesis of the
  complaint is financial in nature, but we at Emmert Dental Associates are more than happy to
  address any complaints expressed by *** *******, and invite the Better Business Bureau to review
  the quality of the treatment, the billing processes, patient experience, or co-insurance
  calculations. *** ******* authorized, requested, and consented to all treatment. No treatment was
  performed without his expressly written or signed consent. He was informed at the outset of his
  treatment needs and financial responsibility. Signed treatment consent forms with signatures
  attached were sent previously and are re-enclosed. Financial disclosure statements specifying
  out-of-pocket expenses and financial responsibility were reviewed by *** ******* and signed by
  him. All treatment was authorized and requested by *** *******. All treatment and financial
  consent forms were signed by *** ******* on the listed corresponding dates-of-service. The
  provided treatment was initiated on an emergent, immediate basis to alleviate acute pain and
  discomfort, as described by *** ******* on his initial visit dated 11/29/22. He requested urgent
  treatment to relieve pain, swelling, and discomfort associated with broken, decayed, and
  deteriorated tooth #14. As of this writing, that tooth is currently asymptomatic and
  nonproblematic.
  At this point, this complaint is simply a smear campaign cultivated by *** ******* to cast
  aspersions on the office and both Dr. M******** and Dr. C********. Dr. M******** repaired and
  restored *** *******’s broken tooth (#14) to alleviate his toothache pain and discomfort on
  11/29/22. Dr. C******** never treated *** *******. But, in an attempt to distract from his feeble
  effort to defraud both the dental office and Delta Dental, *** ******* engages in a pathetic attack
  to harm the outstanding reputation and integrity of the dental office and both practitioners that
  work there. Dr. M******** currently practices under an active dental license that is in good
  standing with the Pennsylvania State Board of Dentistry. Dr. C********, the same. This
  complaint, with its current bullying tactics, spewing vitriolic malice is a form of reputation
  terrorism. The complaint, at this point, is violently hateful, ascerbic, and acrimonious. But, it
  2
  does not mask the fact that *** ******* is trying to obtain an undeserved and unjust refund. He
  says that as much, “Emmert’s assertion that this is merely financial is true.” From our
  perspective, no refund of any kind is due *** *******. We adamantly dispute and contest any
  assertion that a refund is due or that an overpayment was made. It bears repeating that the
  complainant authorized, requested, and consented to all treatment with Dr. M********* Those
  treatment consent forms are signed by both *** ******* and treating dentist, Dr. M********* That
  fact is indisputable. The enclosed consent forms, signed financial statements, and signed
  treatment acknowledgments attest to the validity of the treatment, the cost, and *** *******’s
  awareness of the treating provider. *** ******* consistently attempts to mislead and misrepresent
  the facts of this case for monetary gain. Upon completion of treatment, *** ******* expressed
  concern for his financial liability regarding treatment costs. In response to his concern, the office,
  in conjunction with Delta Dental, conducted an internal office review and audit of his dental
  account. This was done to be as fair and equitable as possible and simultaneously exhibit
  goodwill and transparency. Delta Dental, in response, reviewed both:
  1. Quality of Treatment
  2. Financial Component
  A thorough quality of care review found that the treatment provided by Dr. M********
  was clincally acceptable, without deficiencies, and well within the standard of care. The financial
  review revealed that no overpayment occurred and no refund is due. *** *******’s insurance plan
  provides coverage for only a defined list of services identified within the plan’s benefit
  breakdown. It was determined that the provided services were covered either in-part or not at all.
  In collaboration with Delta Dental, the appropriate percentages were determined and applied to
  the appropriate allowables outlined and indicated in the description of benefits and co-payments
  within the Delta Dental Office Allowable Guide. Office calculations determined *** *******’s
  out-of-pocket expense for all services to be $1304.50. The provided services included:
  1. ***** * Limited Examination
  2. ***** – X-Ray #14
  3* ***** – Second X-Ray #14
  4. ***** – Post-Placement
  5. ***** – Additional Post-Placement
  6* ***** – Crown Elongation
  7* ***** – Temporary Crown Placement
  8. ***** – Occlusal Adjustment
  9. ***** * New Crown Placement
  10. ***** * Crown Insert and Delivery
  Total Cost of Treatment – $1304.50.
  This cost is correct and irrefutable as indicated by the following information. The new
  crown on tooth #14, as prepared and delivered by Dr. M********, was denied by Delta Delta, as a
  result of frequency. Apparently, that particular crown was less than five years old and Delta
  Dental would not cover placement of a new crown prior to that five years. *** *******’s
  3
  post-placement carried with it a cost of $97.50. *** ******* was responsible for 50% of that cost,
  which amounted to $48.75. A second post-placement was necessary for tooth stability and was
  placed by Dr. M********, but that second post-placement was denied by Delta Dental. For that
  second post-placement, *** ******* had a financial liability of $398.00. Crown elongation was
  necessary to restore tooth #14, but that service was denied, as well, by Delta Dental. *** *******
  had an out-of-pocket expense of $411.00 for that service. Based on our calculations, *** *******’s
  total out-of-pocket expense for treatment of tooth #14 was $1304.50. *** ******* paid $1202.00.
  Our records indicate that *** ******* owes the difference – $102.50. Based on the above
  information, and given the fact that *** ******* paid $1202.00, it stands to reason that *** *******
  has an outstanding, past-due balance of $102.50. There was no overpayment. There is no refund
  due *** *******. The outstanding past-due balance is confirmed by the enclosed Delta Dental
  explanations of benefits. To be clear, there is no indication from Delta Dental that there was an
  overpayment of any kind. Based on the Delta Dental allowable applied credits, applied debits,
  and corresponding payments made by *** *******, a balance of $102.50 is still outstanding on his
  dental account.
  Further, the slander spewed by *** ******* in no way changes any of the facts at hand. He
  has provided no new information that would change any of the accounting. He has provided no
  new information that would change the quality of care. In fact, he has provided no new
  information that relates to the topic at hand. He brought nothing new that changed any of the
  information that has been provided previously in multiple responses by Emmert Dental. The
  date-of-service was 11/29/22 and that is unchanged. The practitioner was Dr. Roberto M********
  and that is unchanged. The services provided, which we have listed, were confirmed and
  unchanged. No new information regarding the financial. He has brought no new information that
  could alter nor change any previously presented information. This is merely obnoxious
  repetition. Therefore, we are revisiting something unnecessary – and it is unnecessary because no
  new information has been provided. To be clear, this is an ongoing smear campaign replete with
  reputation terrorism to strong-arm the office into capitulating to his refund demands.
  There was no negligence nor impropriety regarding treatment, the treatment provider, the
  office, nor the practice of the profession. Treatment was provided to *** ******* in the most
  appropriate and professional manner with financial responsibility managed with the utmost
  professional and ethical standards. That, in and of itself, makes this complaint unsubstantiated.
  The office is certainly not in breach of any provider agreements, participating or otherwise. The
  office fulfilled its obligations to complainant *******, regarding provider participating and
  provider conduct by:
  1. Obtaining informed consent for treatment
  2. Obtaining informed financial consent for treatment
  3. Calculating co-insurance appropriately
  4. Prompt claim submission with appropriate coding followed by resubmission, upon
  recognition that claims were unprocessed
  4
  5. Inquiring with Delta Dental to rectify unprocessed claims on behalf of complainant
  *******
  We firmly believe that in an attempt to secure unjust, undeserved monetary gain, Mr.
  ******* deliberately attempted to mislead the Office of the Attorney General by indicating that he
  was treated by a provider other than M********* He is using the Office of the Attorney General as
  a tool to deceptively obtain a refund for which he is not owed nor deserves. According to our
  records and confirmed with Delta Dental, *** ******* still has an outstanding account balance of
  $102.50. In an effort to find resolution, we are willing to disregard the outstanding balance of
  $102.50 and zero-balance the account. With the account balance adjusted to zero, we consider
  this conflict resolved. To be clear, our offices see and treat 200 patients per week and over 800
  per month. The portion of negative comments is less than one percent of the total patients seen.
  Negative comments are easy to make on the part of the complainant but are damaging to the
  reputation of a wholesome neighborhood dental practice that has been in business for over 40
  years with thousands of happy, smiling, returning patients. It is not the happy patients that spew
  inaccuracies, hate, and vitriol, but the singular dissastified patient (*** *******) that attempts to
  cast aspersions on the practice’s impeccable reputation. *** ******* can now take comfort
  knowing that his “yearning for acknowledgment” has brought a zero-balance to his dental
  account.
  Thank you,
  M. B***
  Emmert Dental Associates

  Customer response

  02/16/2024

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.]
  

  
  Better Business Bureau of Western Pa.
  520 E Main Street, Suite 100
  Carnegie, Pa.15106
  ********** ********
  
  February 14 th , 2024
  
  I’m writing in opposition to Steven E C********’s response dated 02/13/2024. Although Steven E
  C******** claims my complaint is “baseless, groundless and without merit” I have shown in my previous
  response plenty of evidence to the contrary. My complaint and evidence shown in previous response
  show not only an attempt at covering up Emmert’s deceptive and fraudulent billing practices, but also
  show a willful disregard for the laws of the commonwealth of Pennsylvania. They want to have
  everyone believe that I’m somehow out for financial gain. To that I will say that I DON’T GIVE A ****
  ABOUT MONEY! That money was taken from me fraudulently whether they want to admit it or not. The
  heart of my complaint is holding Emmert to account for their lies and fraudulent behavior and I don’t
  care if I ever see a dime from them. This is about what’s right and wrong, plain and simple.

  
  I have shown evidence in my previous response that the Frequency limitation that Emmert wants to
  continue to say was the reason for claim denial for the crown on tooth 14 was a lie. Delta Dental does
  have a frequency limitation on crowns for individual teeth of 5 years. The ADA guidelines they attached
  are a generalized guideline in dentistry and show that ins companies generally have a 5–7-year
  frequency limitation on crowns. As previously stated, Delta’s limitation is and was 5 years. My previous
  crown was prepped on 10/19/17 and inserted on 11/02/17. `Crown in question was prepped on
  11/29/22 and inserted on 01/07/23 as shown in figure 1 of my previous response. As a result of this lie, I
  was subsequently billed out of pocket 1575.00 of which 364.00 was deducted for remaining ins benefits
  for fiscal year 2022. This is what got this ball rolling in the first place.

  I have also shown evidence of procedures not performed but billed for as well as procedures being
  unbundled and billed separately when they are part of a completed service and can’t be billed
  separately such as the denial of the crown elongation/crown lengthening claim. That claim was denied
  because it was part of the overall crown procedure, and the claims irrefutably show that but Steven E.
  C******** wants to double down on this lie.

  
  Another thing that Steven E. C******** apparently wants to continue to lie about is that I had no
  procedures rendered by him on my 12/05/22 02 01/07/23 visits to Emmert dental. Steven E. C********
  was the dentist that did occlusal adjustment on 12/05/22 as well as the crown insert on 01/07/23. I
  distinctly remember having a conversation with Steven E. C******** on 01/07/23 where we discussed
  the notes about the work Roberto M******** did on 11/29/22 and that it was an unusual case, but
  C******** thought that M******** had done a good job under the circumstances. So for Steven E.
  C******** to lie as to whom treated me on 01/07/23 is quite surprising. I had originally thought that
  since all my past dealings pertaining to this issue were with Michele B*** that somehow, she was
  misinformed. Considering this response being directly from my treating dentist, I’m even more troubled
  about the situation at Emmert Dental.

  
  I have also shown evidence that Emmert Dental Associates repeatedly changed the treating providers
  on claims to gain payment. For example, Emmert says Roberto ******* M******** treated me on
  11/29/22. (this is one of the only things they are correct on) claims filed for this date of service using
  Roberto ******* M******** as the provider were denied due to either lack of x-rays submitted or treating
  provider was not registered as being part of the practice and wouldn’t recognize his tax ID. Subsequent
  attempts had Emmert Associates inc as the treating provider and were denied. Ultimately the claims
  were paid using Steven E C******** as the provider, which is FRAUD.

  
  What’s very troubling to me is that Emmert continues to say that its irrefutable that I was only
  treated by Roberto ******* M******** but the evidence I’ve shown, and claims say otherwise. If I was
  only seen by Roberto ******* M******** then why do all the claims say Steven E. C******** was the
  treating provider. Are every one of the claims fraudulent?
  Yes, both Steven E. C******** and Roberto ******* M******** are practicing currently under valid
  licenses, but it is true and Emmert has not refuted that both have had their licenses suspended by the
  Pa. Board of Dentistry in the past for the same reasons I have discussed in my complaint. Emmert wants
  you to dismiss my complaints as “bullying tactics, spewing vitriolic malice, reputation terrorism, violently
  hateful, ascorbic and acrimonious” All that is merely playing the victim and to Emmert I would say this”
  don’t lie, cheat, and defraud your patients and Insurance companies and we wouldn’t be here in the first
  place. There’s not a single thing in my complaint or evidence provided that is untrue or malicious in any
  way, it’s merely the truth and the truth is something Emmert Dental Associates, Michele B***, Roberto
  ******* M******** and Steven E. C******** know nothing about.

  
  Let’s be clear again as previously stated I care nothing about the money. I as well as my wife do very
  well financially and in no way need Emmert Dentals money. I have spent countless hours dealing with
  this since 11/29/22. That’s 14 months of visits and calls to Emmert, texts to Michele B***, at least 40
  calls to delta dental, countless visits to Delta Dentals member dashboard, yelp reviews, google reviews,
  4 grievances filed with Delta dental that Emmert didn’t cooperate with, Attorney’s General complaint
  with several responses, and this BBB complaint where I’ve recently sent 99 pages of documentation and
  writing this response to. My time is very valuable in my professional capacity, and I don’t care what the
  amount was that Emmert fraudulently obtained from me, it wouldn’t be worth my time for monetary
  gain as Emmert wants you to believe.Emmert also falsely claims that consent forms are signed by the treating dentist.

  This is not true.Consent forms that were produced by them have no treating dentist signatures on them. Figures 3 and 4
  clearly show that there’s no dentists signature or any other employee of Emmert’s signature on them. Is
  Emmert claiming that a pre-made Emmert Dental stamp with name of business and address proves
  signature of treating dentist. If so that’s laughable. Also, there was a fabricated so-called estimate
  (figure 2) that was manufactured using a previous estimate for a bridge I had done previously. I would
  love to see the original signed copies of this estimate as well as the consent forms.
  
  Emmert claims they did an audit of my dental account. It’s ridiculous to do such an audit with all
  biased information they want to provide Delta Dental with no input from the patients. In other words,
  these audits are easy to manipulate. This complaint has nothing to do with quality of care as I never
  complained about quality of care. Not sure why this is always brought up by them? As far the financial
  component, this was the initial cause for concern after being charged out of pocket for something that
  was determined after talking to Delta Dental to be a covered procedure and that there was no
  frequency limitation whatsoever as previous crown was more than 5 years old. They list the procedures
  on page 2 of their response so let’s take a look at that list and balance of 1304.50
  1-***** covered at 100% no cost to patient
  2-***** covered at 100% no cost to patient
  3-***** not in list of procedures or on any claim submitted to Delta Dental
  4-***** accepted fee 195.00 delta paid 75% leaving a balance owed of 48.75
  5-***** would have been a covered service if properly used in conjunction with ***** but assuming its
  not a covered service according to the claims the balance would be 398.00
  6-**** this claim was denied as shown in my previous response due to it being part of the crown
  procedure and not billable separately to the patient. Clearly stated by delta on the EOB
  7-D**** this is another procedure that’s part of the crown procedure and not billable separately
  8-***** accepted allowance 96.00 delta paid 50% leaving a balance of 48.00
  9-***** no claims for the crown until 9 months after the date of service due to my persistence that
  there was no frequency limitation. Multiple claims with 3 different providers.

  The claim with Steven EC******** is the accurate one of the 3 since Steven E C******** was the dentist who inserted the crown
  on 01/07/23 that claim shows allowance of 655.00 delta pays 491.25 leaving a balance of 163.75.
  10- ***** is also part of the crown procedure and not billable separately.
  That leaves a balance of 658.50 and I paid 1211.00 on 11/29/22. This leaves an overpayment of 552.50.
  it’s impossible to come up with a balance of 1304.50 no matter how you do the math period.
  Again, on the bottom of page 2 of Emmert’s response they triple down on this lie about frequency
  limitations. The evidence I’ve presented more than proves this to be false and Delta Dental has also
  proven this to be false by never mentioning it as a reason for claim denial as well as talking to them and
  confirming the previous crown on tooth was done over 5 years prior. Emmert Dental’s own paperwork
  shows it was over 5 years old. Maybe math isn’t their best subject but when I add 5 years to 11/02/17
  (insert date on previous crown) I come up with 11/02/22 and my new crown was inserted on 01/07/23.
  If you want to go by prep dates that previously was on 10/19/17 add 5 years and you come up with
  10/19/22 and new crown prep date is 11/29/22. Either way you look at it is over 5 years.
  Moving on to page 3. Again, they seem to be having some trouble with the math.
  Post placement-97.50 Delta paid 50% leaving balance of 48.75.
  
  Second postplacement denied although would have been covered had they billed correctly as a *****
  Instead of a *****. ***** is covered when added to a ***** nonetheless that had a balance of 398.00
  even though they accept 141.00 as full payment from Delta Dental
  Crown elongation (D****) was denied due to being part of the completed crown procedure not billable
  separately. Balance 0.
  Also, Emmert wants to keep saying that I paid 1202.00 because this figure is what they altered an old
  estimate for a bridge I had done there years prior. I was billed 1575.00 and 364.00 was deducted from
  that leaving a balance of 1211.00 not 1202.00 that was paid using care credit on 11/29/22. The care
  credit statement was provided in the previous response. The calculations on page 3 in no way add up to
  1304.50 no matter what kind of math you use.

  
  Further Slander is making untrue spoken statements publicly that defame or damage reputation. I think
  you were looking for the word Libel which also requires statements to be untrue just like slander
  requires. The assertion that I have not provided any new information is beyond laughable after sending
  99 pages, most of which is new information concerning this BBB complaint. Who cares that the date of
  service hasn’t changed. Why would it change? That date of service has no relevance whatsoever. I’m
  sure Emmert would love that date to be earlier given the fact they lied about a frequency limitation on
  the crown that’s easily proven false with their own internal documents they gave me. Roberto M********
  was only the practitioner on 11/29/22 not any other date of service pertaining to this complaint. It’s also
  interesting that Steven E. C******** has left out two procedures from his list on page 2. Those would be
  ***** and ***** which were both billed for and paid but subsequently voided and payment rescinded
  due to the ***** never taking place and the ***** being deemed as part of another service already
  paid.

  Evidence of this was also provided to you in my last response that apparently had no new
  information. Steven C******** claims that this is “merely obnoxious repetition” and “unnecessary”. To
  that I say what’s obnoxious is Steven C******** just taking Michele B***’s words at face value and
  doubling down on them without confirming her pack of lies. A simple review of what was sent
  previously would have shown the frequency limitation is false as well as many other lies that Michele
  B*** has propagated. If I had been billed properly from the beginning none of this would have
  happened. This all stems from Michele B***’s deceptive and fraudulent billing practices which kicked off
  with a false claim of a frequency limitation in hopes I would pay and not do my due diligence after the
  fact, and you were wrong. The only thing ever expected from Emmert Dental was to bill and file claims
  properly and they have failed at both of those things.

  
  Just because Steven E. C******** claims there was no negligence or impropriety doesn’t mean there
  wasn’t. Just because he claims everything was appropriate, professional, and ethical doesn’t mean it
  was. Just because he claims my complaint is unsubstantiated doesn’t mean it is. The office has certainly
  been in breach of provider agreements with its ever-changing claims submissions with multiple
  providers for the same service on the same date. To be clear consent forms do not have individual
  dental codes or all procedures listed so it doesn’t give them blanket permission period. There was never
  financial consent given on 11/29/22 or 01/07/23. Emmert had no idea what to estimate prior to me
  being in the chair already due to the nature of the emergency and no estimate was given while in the
  chair either. Emmert has, however, provided a copy of an estimate to the Attorney’s General office
  that’s eerily similar to a copy I obtained a long time ago prior to having a bridge done at Emmert and it
  appears to have been altered to reflect a new amount and date. As far as prompt claim submissions with
  
  appropriate coding can’t be any further from the truth. The reason for so many unprocessed claims
  according to Delta Dental was lack of x-rays and proper tax id information as well as ever changing
  providers being used on claims for the same procedures and dates of service. Also claims were filed for
  many separate procedures that are supposed to be billed as one umbrella of services i.e. temp crown,
  crown elongation and insert of crown are all included in an overall crown service.
  On to the last farce of a paragraph on page 4. Unjust, undeserved monetary gain is what happened
  when you lied about a frequency limitation and charged me out of pocket for a covered crown
  procedure and then waited 9 months to file a claim for a crown only after my persistence you do so. I
  look forward to a day where Steven E C******** sits on a witness stand and says he never treated me
  under oath. That will be very easily proven perjury. I especially love the added touch of inflating an
  already absorbent balance so you can somehow look like a nice person by waiving it. This matter is far
  from resolved and sadly will never be resolved by entities such as the BBB which relies on voluntary
  resolutions between parties and don’t care to be a finder of fact or care to review evidence as its not in
  the BBB’s preview.

  It’s obvious this matter will not be resolved in this forum so you can consider this
  matter unresolved and publish my review. In closing it doesn’t matter how many patients you see per
  hour, day, week, month or year it only takes one fraudulent insurance claim to be found guilty of
  insurance fraud. Emmert Dental is far from having an impeccable reputation and if Michele B*** would
  be as worried about how she bills her patients as much as where her next take out is coming from for
  lunch this probably wouldn’t have happened in the first place so you can acknowledge my yearning for
  accountability for Emmert’s fraudulent behavior
  
  Thank you,
  ***** *******

   

   

   

• Initial Complaint

  09/06/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  May 13th 2023, I needed an emergency root canal, and my primary dentists couldn't fit me in and recommended Emmert Dental Associates ( I recommend you read some of their complaints). My health insurance 100% covers root canals for in network dentist, I called and Emmert confirmed this. The day of my appointment Emmert prescribed me anxiety pills to take an hour before my appointment. Dentists make me nervous. I had taken two pills and while in the waiting room I asked if I could take another and the lady at the front desk said sure. I cannot remember the front desk lady’s name and will refer to her as Beth, so this isn’t so confusing. Then I was called back by the dentist, and they began numbing me. Now that I have 3 anxiety pills and numbing medication in me is when Beth comes back and says I must pay $398 for this visit! I was completely out of it and told her to see my wife to make the payment. I was told a "gum scrapping" was required and my insurance doesn’t cover it. After the initial appointment I called my insurance company, and they told me the EOB hasn’t been submitted yet, but my insurance should cover this, and the term is "tooth lightening". They also said it’s not uncommon to be billed in advance and then reimbursed. My follow up appointment was June 1st to have my cap put on and by then my EOB was posted and it was confirmed my insurance did cover the gum scrapping/ tooth lightening. I told the Beth at the desk at Emmert, and she just brushed me off saying "she is the only person and will look into it when she has time". A week later I decided to just file a claim with my bank. After multiple attempts my claim has been denied because the bank needs an invoice from Emmert showing the services performed so it matches the EOB from my insurance company but Emmert never supplied that. They gave me a tiny gas station receipt with just their name and the amount paid, which doesn’t suffice for my claim. August 24th, I attempted to contact the dentist again and was told I there is nothing they can do because I have an open complaint... I never filed a complaint, and they haven’t been responding to the bank claims. They confirmed by saying that they are ignoring the bank's attempts to contact them. Then I was told to speak to Michelle (Office Manager) and she would be in on Tuesday (8/29). I called and a Michelle answered the phone and told me I need to talk to Beth who is on vacation all week. Beth is the lady who told me to call Michelle! Then when I explained this to Michelle, she tells me "Ohh, there is another Michelle and she’s not in yet. She told me this other Michelle will call me and she never did. At first, I thought they were an unorganized company but what they are doing is deliberant and they are stealing money from customers and fraudulently filing claims. They also filed 3 separate claims for the same appointment to my insurance company, they luckily denied by my insurance company. I have my receipt of purchase $398 and my detailed EOB by my insurance provider showing the insurance company paid $433 for that service.

• Initial Complaint

  08/22/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  On June 1 2023 I had a scaling procedure done at Emmert Dental,2404 Oxford Drive, Bethel Park PA 15102. I was told that I would have to pay upfront for this as they were unsure if this procedure was covered by my insurance. I was told it would be 900.00 dollars for the entire mouth. Only half of my gums were to be scaled on this date as is typical for this procedure. I paid 450.00 out of pocket prior to having this procedure done on this date. The following week I contacted my insurance company and was informed that 90% of this procedure is covered. At this time I contacted Emmert Dental and was told a claim had been submitted. Some time went by and I never received an explanation of benefits regarding this claim. I contacted my dental insurance and was informed a claim had never been submitted. After multiple attempts to have this claim submitted Emmert Dental did submit the claim. The claim was denied due to unclear x-ray images. Once again Emmert was contacted and I was assured they would resubmit the x-rays. After a week or so I contacted Delta Dental and was told the x-rays had not been resubmitted. At this Tim a Delta representative called Emmert Dental. The Delta rep called me back and assured me the x-ray would be submitted again and that I should give the process a month to be resolved After 6 weeks I still did not receive an explanation of benefits. I called Deltal Dental and was informed that due to unclear images the provider would receive 0.00 and member responsibility would be 0.00 dollars. Today I am filing a grievance with Delta Dental. As 90% of this procedure should have been covered and I paid 450.00 I am requesting a refund from Emmert Dental of 405.00. ***** **** **** * ******

  Business response

  11/28/2023

  I am looking into this matter for *** ******* If there is a refund due, it will be issued by 11-15-2023.
  Thank you once again.
  
  Michele ** B***

• Initial Complaint

  05/08/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I went to this dentist on 4-1-23. There I was seen for a cleaning and to discuss replacing my crown. I had a flouride treatment and was molded for a mouth guard. I paid out of pocket for both services as they were not covered by my insurance. On 4-13-23 I went back to been seen to pick up my mouth guard and to start the process of replacing my crown, that I had previously received from another dentist 6 years ago. The dentist was not nice and because very agitated by me because I was having a hard time breathing from the Novocain. I finished my appointment and picked up my mouth guard. Something was not right during this appoinment and I had a bad feeling. I was charged $895.00. The next day I just did not feel right and had no idea what I paid for. I was not given a detailed receipt. I called and the office faxed one to me and there I saw I was being charged and my insurance billed for services that were not provided. I called my insurance and went through the charges and they agreed they were not correct charges for what I had done. I needed to wait until my insurance was billed. When it was billed they billed for Periodontal Evaluation (I did not see Periodontist), Fixed partial sectioning (not done. This is only for bridges and dentures which I don't have), repairing occlusal guard (this was not repaired. I picked it up only). The insurance has spoken with dentist and they have voided those charges. My insurance covers everything and I am only responsible for 15% of allowable. I paid $895.00 and I am only responsible for $105.54. I am not getting any response from previous messages for a refund. I have filed a dispute with the credit card company. I called dentist office again today, for the last time requesting my refund. I am due a refund of $789.46. I am also going to file a complaint with the insurance company. This dentist had scammed me from day one and is now refusing to refund my money.

  Business response

  06/07/2023

   

  See Attachments from the business..

• Initial Complaint

  07/07/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  My issue with Emmert Dental have been delayed since 2021, when I repeatedly noted to them that my claims were being charged as “out of network”. I was told by Emmert staff that this was the fault of my Blue Cross Blue Shield insurance (BCBS) because they were using the wrong business address. Even after I called BCBS to begin the correction, and even after BCBS finally processed the claims as “in network”, I still have not received the refunds that I am owed by Emmert. From a similar issue happening in 2020 under other insurance, my approach had been to pay my charges in full during the visit, then upon receipt of the from BCBS, I would deposit it (BCBS had told me this was fine). Later in 2021, Emmert told me this was wrong, and that I was supposed to give them the checks. When BCBS began reprocessing, I had to repay them for the checks that I had received from them. Claim ********* (Service date: Jan 13, 2021)* ***** ********* (Service date: Feb 10, 2021), ****** ********* and ********* (Service date: Apr 7, 2021), and Claim ********* (Service date: Sept 22, 2021). For these services, I paid $296, $296, $683, and $376 during day of service. During 2021, I also paid $226.40, $150, and $28. According to the corrected "in-network" processing by BCBS, I was overcharged and I paid more than I had to. I think that this process has taken an inappropriately long time and it is difficult to get updates and explanations. Emmert has taken way too long, and with their Pittsburgh downtown office now being closed, and difficulty in contacting the one Emmert financial person serving all three offices, I am concerned about whether my refund will be finalized and sent to me. In one call, it was even implied that I might owe more. My supporting documents are: 1) Receipts from my 2021 payments 2) Emmert Dental 2021 statements 3) BCBS reprocessing/calculating what I owed for the four appointments in 2021. These support that I was billed and paid more than needed.

  Business response

  07/20/2022

  To whom it may concern

  I have personally done three separate audits on this account, and there has been no  overpayment received. All of her claims have been corrected and paid in network. **** ****** was given a refund of $180 a few months ago. After the audit, it was determined that she was not even entitled to that refund. There is no  overpayment, and there is no refund due.

   I feel the issue stems from Payments that **** ****** received in error, that should have been paid to our dental practice. She was responsible to return those payments to her insurance carrier, who intern would forward them to us. 
  
  Sincerely,

  Michele B*** 

  Customer response

  07/23/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.

  As I noted in my message online, I was having trouble finding evidence in my receipts and statements of the "Visa/MC" payment of $408.00 that is listed in the Emmert Statement dated 5/19/2021.  I finally found it (see attached).  The payment was actually made with my American Express.  Thus, counting my payment receipts and this AMEX payment, I paid $2460.40 in 2021.  I do not have explanation of how I owed that much after accounting for my BCBS in-network coverage for 2021.
  

  
  Can you see where I still have a problem?
  
  Thank you, 
  *****

   

  I will start by noting that I had not been informed of the date or the amount of the refund noted by Emerett (not by phone, email, or paper).  After seeing this message, I looked at my bank and credit card statements and found a refund to one credit card account for $283 from Emmert.  While it is nice to see this, it is not enough according to my records and calculations.  In 2021, I paid a total of $2052.40 (as seen with the receipts pdf).  In addition to this, the Emmert Statement of Account dated 5/19/2021 shows that I made a Visa payment of $408.  By any of my calculations/estimates, I have paid more than what I owe when accounting for the BCBS in-network coverage.  (My BCBS annual in-network coverage in 2021 was $1500.)  Though I acknowledge receipt of some payment, it is not enough; I am owed a few hundred more from my overpayment.  The complication in understanding this matter is the lack of paperwork.  Proper handling of this business financial matter could have been done with appropriate paperwork.
  
  Regards,
  
  ***** ******

  Business response

  10/27/2022

  I have read ** ******** complaint and I’m have once again audited her account. There is no refund due to the patient. She still owes money to our office.
  

  Thank you 
  Michele B*** 

  Customer response

  10/28/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  [To assist us in bringing this matter to a close, we would like to know your view on the matter.] 

  I am surprised to be receiving this message from the business in October because I have not received any communication from Emmert since earlier in June.  That June communication was via telephone.  I have not received any additional bill from Emmert.  If there is something else that I owe them, they have not informed me.  

   

  
  Regards,
  
  ***** ******

• Initial Complaint

  04/30/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I received the attached past due invoice in reference to a prior consultation on 01/18/22. This consultation visit was in reference to a wisdom teeth extraction I had scheduled for earlier this year at the Robinson location. Prior to that appointment, I was advised that another dentist wanted to give me an examination. This was despite that fact that the Robinson dentist had already examined me and indicated that the wisdom teeth should be removed. I arrived at the Bethel Park office for the consultation that Emmert Dental requested and upon being requested to have X-rays taken, I questioned why the X-rays I had recently completed at the Robinson office weren’t sufficient. I also questioned whether I was going to be charged for these X-rays. A member of the Emmert staff advised me a few minutes later that there was no charge, so I submitted to the X-rays. I completed the appointment and several weeks later, I received a bill for the amount of $75.00. I called the Bethel Park office and questioned the amount due since it was Emmert Dental that insisted on the second consultation. I was advised during that call that the amount would be removed from my account and I could disregard the payment due. Since that phone call, I have received 3 additional bills for the same amount of $75.00 and spoken to Stephanie, Michelle and finally Jo Marie this morning – who all advised me that the amount due would be removed from my account and I could disregard the bill. The bills keep coming and I am left to consider whether this is simply a lack of communication or there is a concerted effort to attempt to charge customers for amounts due and repeatedly send them invoices in the hopes that they’ll simply render payment to make the issue simply go away. I am also concerned that this amount due will be referred to collections and my credit will be adversely impacted – which will likely result in me having to initiate civil actions against Emmert Dental.

  Business response

  05/17/2022

  To: Whom it may concern

  From: Michele B**** **** ****** ****** **********

  5-17-2022

   

  I have read the complaint, concerning ******* ********** and statements that he received from our office. At this time, *** *********** account does have a zero balance and no additional money is owed to us.

  Thank you for your time in this matter.

   

  Customer response

  05/17/2022

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and find that this resolution is satisfactory to me. 
  
  Regards,
  
  ******* *********

• Initial Complaint

  01/10/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I went to this Dentist's office on December 10, 2021. The Dr. claimed I needed a root canal and a filling done. This seemed odd to me as I wasn't experiencing any pain, or sensitivity to either mentioned area. I wanted to get a second opinion and called the Dr's office to get my X-rays sent to another office. They charged me $15 to send my own X-rays to the second dentist's office and didn't even provide the copy of the X-ray on the proper glossy material for the new dentist to review so I had to get all new X-rays. The check was cashed December 15, 2021. at the very MOST this could have cost $2.51 for microfilm copies. (https://www.health.pa.gov/topics/Administrative/Pages/Medical-Record-Fees.aspx)

  Business response

  02/10/2022

  I have read the complaint from ***** concerning the cost of duplication of records. Our standard Office Policy which was provided to ***** at the first visit, details our duplication  of records charges. ***** signed the copy of our Office Policies.

  The x-rays were  reviewed by one of our general dentists, To make sure they were of diagnostic quality. The x-ray/ x-rays were deemed good quality and were mailed  out. 
  I Would be happy to hear an explanation from the new dentist explaining what was wrong with the x-ray that we sent.

   

  sincerely,

   

  Michele B**** **

  Customer response

  02/10/2022

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and have determined that this does not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  The x-ray copy provided was on 8.5x11 white printer paper and were useless to the other dentist office as they could not be used on the light box to see properly and the new office had to take additional x-rays.

   

  I also understand I signed the office's policy regarding duplication but the office should recognize that it is illegal to charge that much based on State law.
  
  Regards,
  
  ***** **********

• Initial Complaint

  01/09/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Hello, I just received a bill in the mail from emmert dental in Pittsburgh. I went there couple of months ago to get checked for a chipped filling. First thing the ceiling was leaking which i though to be not hygienic or safe for a place i m supposed to trust with my teeth. They had bunch of towels to minimize the leak but it looked dirty. A dentist came in poked me with a cleaning tool and said “you need a root canal and a crown” which was surprising since i know i just chipped the filling. They told me that with insurance it ll will cost me about $2700, money that -to be honest-i don’t have. So i told them i ll need to think about it. The money they were asking me to pay vs the hygienic state of the office was very discouraging. The front desk assistant gave me an appointment and i said i ll see what i can do. I asked her if i had to pay anything she said no. It was also mentioned on their website that new patients were not to pay anything in their first visit. I received the first bill which was $75 approximately and they wanted me to send them my card info instead of paying online.I was going through a rough patch and decided after getting my new job last weeks that i ll pay it even if it s unfair. The bill they sent me today is of $374. Is this legal? How did the bill go $300 up? What can i do in this situation? Please let me know if you need me to provide additional information. Best regards, ***** ***

  Business response

  02/10/2022

  I have read your complaint, and understand your frustration and concerns.  I looked into your account and determined that the amount that you were billed for was the correct total. That amount will be adjusted to zero once you pay the agreed upon amount.

  Thank-you

  ******* **** 

*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. ↩