ComplaintsforStaunton Dental Care

• Initial Complaint

  06/09/2023

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  For the second or third time in the four-plus years I’ve used this dentist, I seem to have a credit on my account that the provider is hanging on to. When this provider bills, they do not show payments made by the patient (me). They only show what the insurance has paid and then try to collect additional money. In this case, based on my calculations, I have a credit of $157.60. I sent a letter on 4/21/23 requesting a full accounting but have gotten no response.

  Business response

  06/13/2023

  To whom it may concern:We have no records or documentation of receiving a letter from the patient requesting a full accounting.  I have no explanation for why it was not received.  We offer our heartfelt apologies for how our lack of response must have felt to the patient.    We take our patient’s satisfaction seriously and strive to answer any questions or concerns that they may have in a timely manner. We received payment from ****** on 04/04/2023 in the amount of $945.60.   The explanation of benefits reflects note #920 which summarizes that the claim was processed using an alternate procedure for each of the two crowns.   ****** changed the code from ***** crown- porcelain/ceramic to code ***** crown- porcelain/base metal even though the crown that was fabricated for both teeth was the ***** crown- porcelain/ceramic.   On the explanation of benefits it does show that the approved contracted amount to charge was $906 per crown for a total of $1812 for those two procedure codes but that insurance would only pay for 60% of $788 each crown.  We charged the contracted rate of $906 per crown according to our participation agreement with ******.  With insurance downgrading the crowns to an alternate benefit, the explanation of benefits reflects that the patient would owe $433.20 per crown.  This left a remaining balance on the account in the amount of $141.60 for the difference in our contracted rate and the downgraded fee.  **** was scheduled the very next day after we received the insurance check, and the balance was explained to him, and he paid the balance of $141.60 that day.    Even though $141.60 was due from the patient, Dr. ******** has agreed to refund that amount to the patient and the request was submitted the same day we received your letter.  Also, an account breakdown for 2023 was sent in the mail today to the patient at the address we have on file.  A voice message was left for the patient on the same day as receiving your letter to please return our call so that we can address any concerns. Please let me know if you have any questions. Sincerely,******* *******Practice Manager of Operations Staunton Dental Care Office

  Customer response

  06/13/2023

  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, ******* ******

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