ComplaintsforAustin Oral Surgery

• Initial Complaint

  02/06/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  My son was referred to Austin Oral Surgery located at ************************************************************************************** to have his wisdom teeth extracted. On 1/26/2023, we submitted our dental insurance to AOS and they called UHC Dental to verify. On 2/8/2023, my son had an in-person consultation at AOS where they confirmed in-network status and that the procedure would be covered as such. On the day of the consultation, we made a down payment of $341.00. On 2/14/2023, my son had his wisdom teeth extracted. On or around 3/15/2023, we received a surprise bill in the mail from AOS for $1,712.00. My wife called AOSs billing department on 3/30/2023 and was told that they called UHC Dental again and was informed that they were out-of-network. Between 4/3/23 4/5/23, I made several unsuccessful attempts to contact AOSs billing department and left four voicemail messages without a callback. I called again on 4/6/2023 and was able to talk with one of their billing specialists. I was told that the procedure was later confirmed to be out-of-network and that I had to address the issue with UHC Dental. I called UHC Dental on 4/6/2023 and the representative recognized the issue right away. From the conversation I understood that provider ************************* has several Provider Ids and when AOS called to verify insurance on 1/26/2023, they gave an in-network Provider Id. However, when AOS submitted the claim to UHC Dental, the Provider ID *********************** with the ********** ** office was out-of-network. Therefore, the claim was processed out-of-network. I had an active appeal with UHC Dental and AOS went ahead and sent it to collections. I am being penalized for AOS's mistake as they were the ones who confirmed in-network status two weeks prior to the initial visit on 2/8/2023 and told us that everything would be covered in-network. If we would have known that AOS was out-of-network, we would have gone to an in-network provider.

  Business response

  02/13/2024

  Patients insurance benefits were verified prior to initial consultation.  The information received back from the insurance company stated that we were an in-network provider with patients policy. 

  The patient was seen for procedure,and insurance was billed for services. 

  The insurance company processed the claim as out of network,stating we are an out of network provider. 

  Insurance companies are adamant that even with a verification of benefits, that this is not a guarantee of coverage.

  Patients parents have been contacted regarding this concern.  Our office has agreed to remove account from collections and adjusted the remaining patient balance.  

  Customer response

  02/14/2024

  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

  12/11/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  12/11/23 I went to get two of my wisdom teeth extracted, I was told that all wisdom teeth removals require IV sedation, which is not true. They quoted me 2000$ for 2 teeth to be removed and when I refused i was told I would have to pay 320$ for the x-ray and examination i received but was never informed that i would be charged for. For reference just a hour earlier on that same day i paid 60$ for a xray and examination, this dental practice price gouges

  Business response

  12/29/2023

  Patient is disputing the amount that he was charged for his examination and panoramic x-ray. Patient was worked into the schedule on 12/11/23 for an examination and possible surgery. Patient was told when scheduling that he would be financially responsible for services that day,no cost had been discussed as the patient had not yet been seen in the office.After patient consulted with the surgeon, he was presented with two separate treatment plans. The first treatment plan included total costs for the examination,x-ray, and removal of 4 teeth under IV sedation. The second treatment plan included total cost for the examination, x-ray, and removal of 2 teeth under IV sedation. Patient chose not to move forward with surgery leaving his financial responsibility the cost of the examination and x-ray. The surgeon is a specialist so prices may vary from other dental practices. Adjustments have been applied to patients account; only financial responsibility is $130 for the exam with the surgeon. 

• Initial Complaint

  08/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  patient account: ****** amount: $625 I was quite satisfied with my servicelast April 26, 2023 with Austin Oral Surgery. However, I have tried to reach out to management because I received an additional bill a year later for this service. I initiallywent over every billing cost with the registration team to assure my insurance would cover the wisdomteeth procedures that were performed and to give them my out of pocket costs because I did not want any surprises and could only afford my budget range. The young lady who I spoke with on May 8th of this year (2023) about this new bill, again which came a year later, told me it came because I was still in a waiting period. I informed her that this should not have occurredbecause the team ran my insurance and I would not have received the procedure if I was informedI was still in a waiting period. She hung up when I asked to speak with a manager. I reached out again earlier this month and was only told by email to make a payment in 10 days before collection notice. It was strange to me because the employee I spoke with on Aug 4th had spoke to their supervisor, apologized, and told me they would reach out and resolve the billing error. I made a payment on yesterday out of fear, but I know this is not good practice. I had a smooth surgery and registration process, I just want to make sure this issue is rectified.

  Customer response

  09/18/2023

  Better Business Bureau:
  
  Austin Oral Surgery immediately reached out to me following the complaint, apologized, and refunded the full amount. 
  
  Regards,
  
  Zion Hall

• Initial Complaint

  03/16/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I am raising a complaint regarding a dental extraction and implant procedure that I underwent with ********************. I was not informed upfront about the overcharge for these procedures, which has left me dissatisfied. Despite my attempts to resolve this matter through several calls and a written letter, I have not received any response to my letter. Calls 12/01/22 8:41AM 12/02/22 12:55PM 12/12/22 1:48PM 01/06/23 3:54PM 01/09/23 1:59PM 01/10/23 10:00AM Letter on 02/06/23 I did receive a refund $425.60 for the extraction.I am seeking a refund $1170.00 for overcharging me for the implant procedure.Thank you History On April 22 I visited ******************** for a tooth extraction and bone graft. Delta Dental my insurance does on cover the procedure and I was charged $745.00 for the procedure even though it is clearly stated that the accepted fee is $322.00 Accepted fee (The accepted fee is the amount you dentist agrees to accept as full payment for your dental service) $322.00 Delta Dental pays $0.00 Your cost for this procedure $745.00 On September 1 I visited ******************** for a tooth implant Accepted fee (The accepted fee is the amount you dentist agrees to accept as full payment for your dental service) $1,825.00 Delta Dental pays $0.00 Your cost for this procedure $2,955.00

  Business response

  04/20/2023

  Patient is disputing the amount he is obligated to pay vs the contractual. The Explanation of Benefits (***) even states this is a non-covered procedure, and the portion patient pays is the full practice fee from patients insurance.

  
  The office collected for this procedure in full due to verification of benefits showing this was a non-covered benefit on patients plan.
  
  11/28/2022 patient spoke with billing stating we sent the claim with errors, patient was informed the claim processed correctly and procedure codes are a non-covered benefit on patients policy.
  

  12/1/2022 patient left a voicemail with billing to discuss the amount of his implant and requesting to pay the contracted amount. The patient was informed this was a non-covered benefit. Patient disconnected the call. We attempted calling but went to patients voicemail.
  
  12/2/2022 received an email to reach out to patient in billing, we reached out and informed because insurance did not cover the procedure, he is responsible for the full amount. The patient wanted to know what his cost would have been as a self-pay patient. 
  
  12/12/2022 patient left 3 voicemails with billing to review account. Called patient back, no answer so we left a voicemail
  .
  12/15/2022 patient left a voicemail, we called back but wife stated patient was unavailable and would provide patient with the information we called.
  
  
  On 2/7/2023 patient brought a letter in to the office discussing his perceived overcharge.
  
  The treatment plan was provided to patient on the day of the consultation, quoted with the non-covered benefits. The procedure was rendered within 60 days, on 9/1/2022. Patient was made aware of his total out of pocket expense prior to the procedure. We are not obligated to take an adjustment on a non-covered service, specifically if the insurance company is listing what the patient owes.

  Please reach out with any further questions.

  
  

  Customer response

  04/26/2023

  Complaint: 19598870
  
  I am rejecting this response because:

  As a patient, I should have the right to be fully informed of the costs associated with the services I receive. This enables me to make informed decisions about my dental care and determine whether I want to pursue alternative options. It is unethical not to disclose the higher rate for uninsured patients, which is a fundamental right.

  
  It is essential to be transparent with patients about these cost differences. This will not only empower them to make informed decisions but also ****** trust and loyalty in your practice.

  
  In light of this, I request the following:
  - Clearly disclose the difference in pricing for insured and uninsured patients before scheduling an appointment. This can be done through your website, over the phone, or during the initial consultation.
  - Inform all new patients of the higher rate for uninsured individuals before proceeding with any dental procedures. This ensures that they are aware of the costs involved and can make an informed decision about their treatment.
  - Refund the excess charges that were not disclosed to me at the time of my visit.
  

  By implementing these changes, your practice will demonstrate a commitment to ethical business practices and ensure that all patients are treated fairly and with respect. It is essential to prioritize transparency and honesty in all aspects of your business, and I believe that making these changes will only serve to enhance your reputation and the trust your patients place in you.
  
  Regards,
  
  **********************

• Initial Complaint

  03/09/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Date of transaction/service = 7/7/2022. Amount of money paid to business = $4625.61. We paid to have oral surgery performed on *********************** who is my son. We have no complaint regarding the quality of work done. My complaint is that we were asked by Austin Oral Surgery (AOS) to pay in full, in advance, the out of pocket maximum that our insurance ****************** (UHC) showed us owing. We paid that on 6/30/2022. The entire procedure was pre-authorized by UHC. What happened next is that OAS did not submit the claim in a timely manner to UHC and OAS did not submit the correct procedure codes which resulted in UHC not fully paying OAS. This delay also resulted in all of the other parties involved such as the facility, anesthesiologists, other oral surgeons, etc billing us because UHC showed that we had not met our deductible and out of pocket maximum(OOPM) so all the other parties filed claims against us. We claimed that we paid the full amount of the deductible and OOPM to AOS so we should not owe any other party any more money. We were then hounded by bill collectors for the other parties and were threatened to be put in collections so we started a payment plan to the other parties. This has resulted in us paying even more than we owe. AOS is dragging their feet over refunding us our money so we can repay the other parties. We have made at least 18 phone calls and numerous emails between UHC and AOS over the last 8 months and still do not have our refund. The best that AOS can say is that they are working on it...submitted more medical records, etc. Our account number for AOS is ******. Please help us resolve this issue.

  Business response

  04/14/2023

  For Date Of Service:7/7/2022 the patient is referring to an orthognathic case which processed and paid in February of 2023. To finalize payment, we worked with the insurance company with multiple follow up calls throughout the process for this hospital case. A refund has not been processed at this stage, due to the patient having an outstanding claim for another DOS, which is still processing, and therefore a balance is on the account until the claim is paid. We have remained in contact with the insurance company consistently through follow up and providing additional information for the claim to be covered through the patients insurance. This can be common with these type of hospital cases when you are working through individual health insurances companies. Although we complete a preauthorization for the specific codes and surgery, it occurs often that carriers request additional records to support the determination around the procedure being a covered service.
  
  Please see interactions below with the insurance company over multiple occasions.
  
  The two claims for DOS:7/7/2022 were sent on 7/11/2022 & 7/12/2022. The insurance company (United Healthcare) requested additional information on 8/18/2022 for the original claim and we sent the details requested. On 9/13/2022 the insurance company requested additional information to process the claim. On 10/27/2022 we were notified by *** that we were needing to resubmit the information for a second time. We continued tracking the status of the claim and as of 12/28/2022 when we checked the status of claim that showed pending/in process.
  
  On 1/3/2023 patient called stating records were not received by ***, we informed patient these had been submitted multiple times; provided a different fax # with reference # of rep he spoke with. We called *** to clarify medical records sent via fax and were informed these were not received. We then resubmitted records through the *** portal to ensure these were received with proof on both ends. A rep from *** called us on 1/19/2023 to inform us medical records were received and should process in a couple days. On 1/19/2023 the patients father called us stating a rep was requiring more information verbally, so we called *** and were informed no additional information was required on 1/20/2023.
  
  On 2/1/2023 a *** rep called us stating payment processed and was on its way although a portion of the claim denied due to requiring pre-authorization and stated no pre-authorization was on file for procedure codes 21196/21143. This information was previously sent and informed the rep of the approved authorization # on file; rep was able to locate this approval and sent the claim back to re-process with approved authorization #. On 2/7/2023 we received the first portion of payment for claim for procedure code *****. On 2/7/2023 we were informed by *** the remaining portion of the claim should process by 2/10/2023.
  We received the first payment on claim for DOS:2/7/2023 on 2/7/2023 & the second payment for remainder of claim on 2/20/2023. Patient still shows a balance while another DOS is still in process, informed by *** on 4/12/2023 this will finalize within ***** days.
  
  Please reach out with any additional questions.

  Customer response

  04/17/2023

  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

  05/03/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  This $319. **** was paid by check two years ago! I paid well over $1,000, Insurance paid 2k. All paid two years ago. Their billing department is the WORST. Two years ago I went through this aggravation w/billing. After numerous calls back to Austin Oral, ***************************** searching for payments. They actually OWED ME $100.+ WHICH THEY NEVER PAID. DIDN'T GET MY MONEY YET THEY START BILLING ME AGAIN.Two years later they're billing me again! I wrote a letter to them enclosed w/invoice. What's really fishy here is this ****. They told me I had to pay by CHECK made out to Oral Pathology A** some outfit in ****,** to do my biopsy. Apparently there isn't a PATHOLOGY in Austin that takes ***************************** Neither does the **** lab. Certainly worth looking into those businesses for "conflict of interest" or worse possible kickbacks. Copy of the Check. Billing Invoice, a CC payment, *************************************************, MD *******, ** ************ I want a billing adjust of $00.00. and a REFUND OF $100.

*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. ↩