ComplaintsforForest Smiles

• Initial Complaint

  02/17/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Dear BBB. I'm writing to ask assistance in resolving a billing dispute with Forest Dental, **** ****** ***** ******* ******** ****** Amount of bill is $29.20. I have dental insurance with ***** Dental that provides for two free dental exams with cleaning and one set of x-rays per year with zero co-pay/deductible. I have had ***** dental insurance for 7+ years and never paid a co-pay for in-network dental exam/cleaning/x-ray services whenever I received dental care where ***** was accepted. I was seen on 22 Dec 2023 at Forest Smiles and received an exam, cleaning, and x-rays. The services were carried out satisfactorily. Since I'm new to the ******, ** area, I researched Dental practices in my zip code area prior to accepting this appointment with Forest Smiles. When I initially called Forest Smiles, I asked them two questions; (1) are you accepting new patients; and (2) do you take my dental insurance as in-Network at your facility? The answer to both was "Yes". I gave them my ***** Dental insurance information as follows: ***** Dental, *** **** ******* *** ************* *********************************** *** *** * ********** ***** *** ****** Forest Dental confirmed my insurance with ***** and reconfirmed I was in-network for dental care; and then they scheduled me for my exam, cleaning and x-rays for 22 Dec 2023. Since the service, I have received numerous duplicate bills for $29.20 balance due, which I was told was my "out-of-network" portion of the bill for dental services received on 22 Dec 2023. When I asked Forest Dental why I was being billed as out-of-network instead of in-network, they said they did not know. This is in complete contradiction to the verbal confirmation prior to my appointment that clearly stated my ***** insurance would be accepted as in-network. Despite numerous phone calls and two in-person visits to Forest Smiles, they simply dismiss me stating the office manager will reply, yet never respond to resolve this dispute.

  

  Business response

  02/21/2024

  Thank-you for your feedback.  Unfortunately, HIPPA does not allow me to directly comment on any specific patient situation in a public forum.  What I can tell you is that we do our best to inform our patients about our process in the office.  Before we schedule any patient in the office, we provide them with a new patient packet.  This packet is reviewed and signed prior to any appointments scheduled.  This packet outlines our office policies for billing, insurance, x-rays, etc.  We verify insurance for all of our patients.  However, we can not confirm payment from any insurance carrier.  We file insurance as a courtesy to our patients.  Patients are responsible for any amounts not covered by there insurance carrier.  Unfortunately we cannot guarantee payment from an insurance carrier for any of the work we do in the office.  I hope this information helps.Dr. *********

• Initial Complaint

  08/17/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I went to see Forest Smiles as a new patient 3/27/2023, My insurance carrier is ****** **** ********** ****** (which has medical and dental combined, then a separate dental plan) Forest Smiles refused to file the insurance claim because of medical and dental being combined, sent directly to dental plan, which I advised that the medical/dental had to be filed first, and then they send it to the dental plan. Total bill for that date was $320.00; (I paid $28.00 for the fluoride treatment) Insurance paid. As a preferred provider they can only receive payment for the allowable amount which was $160.00 (on 6/14/2023 the insurance paid $91.30, and on /19/2023 paid $68.70 for 3/27/2023 date of service, I paid $28.00) = $188.00 -- on 5/5/2023 charges allowed was $418.00, which the insurance paid $292.60, and I paid $200.00 =$492.60, (insurance advised patient owed $125.40) I received an invoice from Forest Smiles with $3.26 finance fee, no other information as to what insurance payments they had received, so I requested a customary bill. When I receive customary bill on which I find that they had a $50.00 charge for non-cancellation for an appointment for 6/8/2023, which an email was sent to them cancelling the appointment on 6/6/2023 (since they wouldn't return my phone call) I sent them a letter (August 7, 2023) showing the entire breakdown of insurance EOBs and that the failure to cancel an appointment was unwarranted, and the finance fee should be removed, since they owe me money ($102.60). I have yet to receive a phone call or my refund in the amount of $102.60 as I requested in my letter, which was received by them Thursday, August 10, 2023 per certified mail receipt

  

  Business response

  08/27/2023

  I am sorry to hear about all the confusion.  At the time your overdue notice was sent your insurance company had not paid on its claim and you had an outstanding balance with our office.  We had spent several months submitting the claim with no response.  A couple days following the receipt of your letter to our office, a payment from your insurance provider on your claim was received.  Our office manager was on vacation and when she returned the check was entered and this led to a credit on your account.  The credit was promptly paid.  Hope this clears up any confusion.

  Customer response

  08/28/2023

  I have reviewed the response offer made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.  I received a refund check, after I sent a detailed letter of what the EOB I had received showed, and what I had paid. There was $102.60 that I showed them was owed to me. I hadn't received an EOB for what they are stating in their response to BBB.  So the statement is false when they are saying I had a balance due, I received an invoice showing $3.26 finance charge, and nothing else on the invoice.. They said I was being charged $50 for failure to cancel an appointment, when in fact I cancelled it 2 days before it was scheduled.The front desk, office manager, ********, is a bully, rude and disrespectful.  Unwilling to follow a patient's instructions on how to properly file the claims, my medical/dental is my primary, and the dental was secondary.  They refused to file with the medical, they failed to return my calls, and when I did manage to speak to someone, requesting that the insurance company would call and explain, I was told "they didn't speak to insurance companies".  I don't know how a business is supposed to have claims filed, when you refuse to follow instructions.  If that would of happened, it wouldn't have taken 3 plus months to have the problem resolved. Regards, ****** ********

• Initial Complaint

  07/11/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Paid in advance of service. Business changes schedule times without verbally contacting patient directly to accept changes in time of appointment. Business ignores requests for problems concerning health/surgery related prescriptions.

  

  Business response

  07/17/2023

  I am sorry to hear this.  Unfortunately, HIPPA does not all me to discuss patient information in a public forum.  However, I can state that our office policy is to use text and email reminders for all patient appointments.  We send reminders at two weeks, one week, 72 hrs., 48 hrs., and 24 hrs.  All of our prescriptions are written electronically and sent via secure data encryption to patients pharmacy via computer.  For scheduled surgeries we enter prescriptions prior to appointments times.  This ensures patients enough time to pick up prescriptions prior to scheduled surgical appointments.  

  Customer response

  07/19/2023

  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved. Regards, **** *****

• Initial Complaint

  11/15/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  This complaint concerns getting billed for a treatment my that my dental insurance only pays for 3 x every years. I specifically told the representative that called me before my appt please check to see if there's any additional cost for going to my appt early and any hidden charges you all may do before me arriving to my appointment. This 2x a year cleaning only is what I asked for but the rep took it upon herself to do panoramic xrays and I simply said this is something new I am not use to this, she said oh no it's like the other mouth xrays but we have a new machine. therefore, she lied and took it upon herself to do this. I gets a bill within a month for $75.11 which I was very upset because I ask before I came, and I told her when I was there I'm not use to this. However, the blind sided of the office is money hungry and I am very livid and will not be going back. They sent the bill to a collection office which I never received any bills from the office I went to the office in August when my dental insurance called to tell me they do not cover the procedure they did. I mailed a check off for $37.00 on 11/15/2022 to meet them halfway and the supervisor of billing said she will return the check back to me because the bill was sent to collections. I asked them to stop all calls and decease all mail from there office. I will no longer go to there office they all unprofessional and money greed. The number for this practice ###-###-####

  

  Business response

  11/16/2022

  Mrs. ****** was seen 06/23/2022, she was made aware of all services provided. Once insurance paid she was unhappy they did not pay for her pano, she consented to all services performed.  Insurance was reviewed with her that we are happy to file her insurance but can not guarantee what they will pay, we file insurance as a courtesy. She was sent statements 07/26/2022, 08/25/2022, and 09/22/2022, her account went to collections 10/19/2022(she was made aware at the 09/22 statement if not paid her account was going to collections). She called 08/19/2022 inquiring about her bill and stated she would pay on it which she did not. Attached is the copy of her statement transactions and her call. No mail was returned and she was aware of the balance but disregarded paying her bill. Thank you

  Customer response

  11/17/2022

  I have reviewed the response offer made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.  I went To the office back in August never called because no one never returns my call told them I was Blind sided by what they did & if they can’t call my insurance before coming then I would of did it myself. Therefore, when coming I asked the representative was there anything extra they were doing she simply said no just a routine cleaning as usual. So for them to say I’m responsible for the bill they are responsible to verifying my insurance, which they don’t & several complaints has come to me about this location & the staff members. I never once said I would Pay the bill I said I’ll pay half the bill due to their staff negligence and I sent $37.00 dollars and the billing supervisor on Monday Nov 14th said she will return my check because it went to collections which I definitely wasn’t aware. However, if they return my check then they don’t want to get paid. Due to COVID & my budget I would Have cancelled my appt for $75.00 dental visit & went elsewhere. Regards, ********* ******

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