ComplaintsforRenova Smiles

• Initial Complaint

  06/19/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  I am upset that ReNova Smiles left a "file" in tooth #3 during an earlier routine root canal. On a separate matter I need a receding gum issue on one of my front teeth and got referred out to another dentist to have this work done which was perfectly fair. However, the receding gum dentist later told me there was a problem with tooth #3 and referred me to another dentist to have an evaluation done. The evaluation came back stating that there is a "Broken file in Palatal root". Tooth #3 later had to be extracted due to infection. Tooth #3 was then extracted by ReNova Smiles; I had an insert done on tooth #** which as fair as far as I know the implant this implant has gone well and a bill was paid on that tooth insert which is perfectly fair. But I don't see why a bill was generated to pay for the extraction of tooth #3 (this bill was paid too). I believe the bill for extracting tooth #3 should be refunded. In a brief conversation with a **. ********************** I spoke to him about this and he told me that: (1) the file was in tooth #3; and (2) he does not "handle money issues".

  

  Business response

  06/21/2023

  To whom it may concern:

  We greatly appreciate the Better Business Bureau reaching out to us regarding the opportunity to respond to this complaint.
  
  We sincerely believe that ************ may be confused. He visited our practice on an emergency basis on 06/12/2023 with a pre-existing broken file (x-rays enclosed). Caring Dental referred *** **** to us for the extraction of tooth #3. On the same day, at his insistence that the services were going to be paid by his church (***************** Church), we fulfilled his request for the extraction of tooth #3, along with a bone graft and membrane, as well as the placement of an implant on tooth #**. It is important to note that we did not perform any root canal treatment or provide any treatment related to tooth #3. Therefore, we are perplexed by his request for a refund, as he should inquire about his root canal procedure with the practitioner who performed it.
  
  Enclosed, you will find the x-ray and clinical notes from the date of service, 06/12/2023.
  
  Please do not hesitate to contact us if you have any further concerns.

  Sincerely,

  ***********************

  RenovaSmiles General Manager

• Initial Complaint

  11/10/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have been asking for a year to be provided a summary of charges that are both insurance covered and paid in full by my family. Each time I am told I will receive it but all I have received to date is one dental visit of charges. My insurance company has informed me repeatedly I was mischarged and they owe me money. However, they will not provide documentation or correct the issue.

  

  Business response

  11/18/2022

  November 18th, 2022

  Dear ******: 

  Thank you for contacting me regarding this patient's complaint to the BBB, and for giving us the opportunity to explain our side. **** ****** ***** became a patient on 04/26/2021 and added her family members ****** ***** on 06/08/2021 and ********* ***** on 12/10/2021. 

  1. ****** ***** history: Patient brought ****** insurance card. Eligibility was verified with ****** 
  DOS 04/16/2021: Total charges $225.00. Insurance payment was $189.00 and per insurance, the patient was responsible for $25.00 of which **** ***** paid $5.00 on date of service, leaving a balance of $20.00. See Explanation of benefits attached. Treatment recommended consisted of a filling on tooth #** (patient had a chipped filling already, doctor explained patient filling might not last and might come out again if she bites on it). 
  
  DOS 04/23/2021: Patient decided to proceed with the filling on tooth # **. Total charges $131. Insurance breakdown: Insurance payment of $102.00 and the patient's responsibility was $29.00. Patient paid $53.00 ending up having a credit of $4.00. See Explanation of benefits attached. It was stressed to the patient the filling may fall off again due to the location and her bite. DOS 05/07/2021: **** ***** returned with a complaint the filling came out, the doctor redid the filling at no charge to the patient neither to the insurance and explained again about the risk of the filling coming out again due to the location and her bite. **** ***** was thoroughly explained the reason why her original filling fell off, and the risks of continuing to try to fill the tooth in a location where it would likely chip or fall off. 

  DOS 07/05/2021: After 2 months she returned with the same complaint - the filling came out. Charges for an emergency exam were sent to her insurance with a total of $85.00, we received no payment from her insurance and as a courtesy to her we adjusted her account the amount of $81.00, leaving her with a balance of $0.00. Her filling was redone at no charge to her or her insurance for the second time. Patient was rude to the doctor, refused to take xrays and didn't want to hear the doctor's recommendation and diagnosis cutting the conversation rudely. 

  She was explained about her grinding habit, having to use her front teeth to chew, the location of the filling as the reason her filling has come out multiple times, even though it had been done various times by numerous providers inside and outside of our practice. She stood up after the filling was done stating she's not a grinder. 

  DOS 07/31/2021: **** ***** returned again with the same filling off. This appointment she was seen by Dr B*******. Dr. B******* explained that this filling would not last due to the location, and that he did not recommend re-doing it. Dr B******* redid the filling at no charge, and performed enamelplasty of her adjacent teeth at her request. **** ***** was charged nothing 
  for this visit. 

  On 10/28/2021 We called **** ***** as a courtesy to let her know her dental insurance was terminated, she mentioned, "I think I have ****** **********, " we asked her if she has her insurance card with her to give us her ID and the phone number to verify her benefits before the appointment, she rudely stated, "I can't locate my insurance card, I'll bring it tomorrow". We tried to located her policy under her SSN and demographic information with ****** ********** Insurance and could not find her. 

  DOS 10/29/2021, **** ***** checked in with an attitude implying we needed to know her insurance and she's not terminated. We were able to pull up her information with ****** ********** insurance and explained she was terminated as of 08/15/2021 (see attachment). We gave her a copy of the information, which she refused to see, screaming she has an active policy and yelling that it is our responsibility to know her insurance. I personally explained to her that insurances don't notify us when a patient is terminated, it is the patient's responsibility to check with their employers about any changes on their policies. We offered her a previous special for $99.00, even though this special was no longer running with our business as a courtesy, and informed her if she discovered she had another insurance policy, that we would submit the claim, and if there was any money to refund to her, we would do so immediately. The patient was once more unhappy and very difficult to please even though we did more we were obligated to do for her. She requested to send a claim to her ****** ********** insurance even though was terminated, we did so at her request. On 11/20/2021, **** ***** updated her insurance, she now had ***** Dental insurance. We verified and submitted the claim for DOS 10/29/2021 to ***** Dental as well. ***** Dental paid on 12/20/2021 the amount of $52.00 for her exam and cleaning, we had to wait for the denial from the previous insurance in order to adjust the account. On 01/07/2022 we received the answer she was indeed terminated and we adjusted her account including her portion of $46.00, leaving her a credit of $53.00. 

  **** ***** scheduled her next cleaning on 05/06/2022, she did not show for her appointment and she was charged our broken appointment fee ($50.00) that is part of our Payment Policy which she was aware of and signed upon initially becoming a patient of ours. On 05/23/2022 as a courtesy, we adjusted the account for $50.00 even though this was her second broken appointment.. 

  **** ***** rescheduled her appointment for DOS 06/27/2022, a claim was submitted and the insurance paid $52.00 leaving a patient responsibility of $46.00 (see EOB attached), this amount was applied to her credit leaving her on her account a credit of $7.00. 

  **** ***** had an emergency on DOS 10/10/2022. The claim submitted to the insurance was for the amount of $70.00 from which according to the insurance they mailed a check for $38.00 and she was responsible for $32,00. The insurance check was never received and we requested to have it reissued by the insurance company - this could take up to 45 business days according to them. Applying what the insurance told us, the account had a balance remaining of $25.00. 

  2. ****** *****: DOS 06/08/2021 Patient came for her new patient exam, xrays and cleaning for a total of $197.00. The patient paid $10.00 according to ******; **** ***** insisted she has ****** ********** and she shouldn't be paying anything; we explained her that her ****** policy doesn't pay anything to the office and $10.00 is her copay. She was very rude and insisted we submit the claim to ****** ********** which came back denied saying patient needs to pay $397.00 for this service due to no coverage; we adjusted the account as you can see in her account and charged her only the $10.00. ****** came back on 12/21/2021 - total amount billed to insurance $233.00. We collected the estimated amount of $96.50 according to the benefits we had on record. **** ***** became very upset and rude with the front desk, she insisted again that her policy with ****** ********** was active. We submitted the claim to both insurances and ****** ********** returned denied. ***** Dental insurance paid $55.00 and left a patient responsibility of $56.00. This left a credit on ******'s account of $40.50. Patient had 3 broken appointments for the following dates: 06/27/22, 07/11/2022 and 10/10/2022, each broken appointment fee is $50.00 having a balance of $150.00 which was adjusted as a courtesy; even though **** ***** still accused us of overcharging her. This left a credit of $40.50 on Peyton's account. 

  3. ********* *****: DOS 12/21/2022 Patient came for his new patient exam, xrays, and cleaning for a total of $182.00 of which the insurance paid $78.00 leaving a patient responsibility of $104.00 ( See Explanation of benefits attached). The patient was recommended a Night guard due to bruxism, the patient agreed. According to the benefits that insurance sent to us, a Nightguard was a not a covered service, total amount for the night guard was $660.00. We applied a $180.00 courtesy discount leaving a balance of $480.00. We still submitted the claim to ***** Dental because sometimes the breakdowns are not accurate until the actual claim is processed and explained to the patient: if the insurance pays for the Night guard we will make any necessary adjustments to the account as we had many times previously. The Insurance paid $306.00 toward the nightguard stating that patient responsibility was $175.00 for the night guard. The total patient responsibility for DOS 12/21/2022 was $279.00 from which patient paid $480.00 leaving a credit of $201.00 on 01/25/2022 (date when we received insurance payment and adjustments were done accordingly). 
  
  In the meantime, ********* came back to have a crown and a build up done on DOS 01/07/2022 with a total of $1046.00 submitted to the insurance. The insurance paid toward this service $803.00 leaving a patient responsibility of $243.00. We applied the patient's credit of $201.00 from DOS 12/21/2021 leaving a balance of $42.00 on *********'s account. Patient came back on 01/28/2022 for his crown delivery and xray (required for delivering crown) and the total submitted to insurance was $18.00. The insurance paid $10.00 leaving patient a balance of $8.00. This left the total balance of $50.00 on the account. No payment was made toward the account. Patient return on 02/26/2022 for fillings and a total of $336 was submitted to insurance. The insurance did not pay due to patient having reached his annual coverage maximum, stating the patient's responsibility was $336.00 (see explanation of benefits attached). The patient paid $67.20 leaving a balance on his account of $318.80 (including past balance of $50.00). The patient scheduled a cleaning appointment on 03/26/2022. The total was $64.00 for the cleaning and the patient purchased MI Paste (prescription medication) for $25.00. This was the only payment **** ***** made, stating we were overcharging because her insurance was to pay for his fillings. We explained he was maxed out and the insurance would not pay. As a courtesy, we offered to honor our contracted insurance fee. We let her go without payment because she stated she would contact the insurance and stated, "we should do our job." We submitted his claim for the cleaning even though the patient was maxed out as she insisted the insurance would pay. Insurance came back stating $64.00 was the patient's responsibility for this cleaning. This left a balance on his account of $382.80. 

  After all the explanations, the total balance on the account was $407.80 (for **** ***** and *********). We applied the credit of $40.50 (from ******'s account) leaving a true balance of $367.30. As you can see there was never any overcharging on our part and we follow closely our contract with patients' insurances, making any necessary adjusted in a timely manner and offering numerous courtesies to the patient and her family. **** ***** still has a balance with us of $367.30. On the ledger you will see a different balance because we never received the insurance payment of $38.00 as I explained before on **** ***** account history. 

  I hope this has explained to you the entire situation that we had with this patient and you can resolve this complaint in a good faith. As a business we respect all our patients' rights and we follow very closely all protocols and contracts with the insurances that we accept; no treatment was done with the patient agreeing and always a treatment was plan presented with estimated portions due. Please, let me know if you have any other question. 
  

  Sincerely, 
  Gloria B**** 
  RenovaSmiles GM 
  

*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. ↩