ComplaintsforSouth Hill Pediatric Dentistry

• Initial Complaint

  08/13/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  August 2nd 2022, I received a call from a collection agency. The woman stated that I had been turned over to collections due to an unpaid **** from South Hill Pediatric Dentistry dating back to 2019 in the amount of $833.05. The **** was for both my daughters who were both covered by two different insurance companies, in the past we have never had to pay anything out of pocket for their dental. Both insurances always covered the entire ****. Last I spoke to South Hill Pediatric Dentistry, I was told that the secondary insurance didn't cover any of the **** and they were resubmitting the **** to them. They told me not to worry about it. Unfortunately, in 2017 my daughters were involved in a school shooting, after 2019 school year was over, we moved and relocated to get them closer to family for support. I did have our mail forwarded and I have had the same phone number since I was 17 years old. Never once did I receive notification by phone or mail that the amount was now due. The first-time hearing about this **** that was due was August 2nd when the collection agency called me. On August 3rd I called and paid the balance. I received an itemized statement from the collection agency a few days earlier that shows our secondary insurance never did pay. There is no way for me to go back that far and determine what should be paid, my husband company constantly sells out to other companies and our insurance always changes. This is the duty of the provider. They take copies of the patient's insurance and it's their responsibility to **** insurance. It is my responsibility to pay anything insurance DOES NOT COVER. The provider failed to **** our secondary insurance correctly resulting in a balance due. Also violating HIPPA by submitting an itemized statement of my two daughters visits to an authorized third party. The provider failed to contact me and follow up with communication on expecting a balance due before submitting my information to a collection agency.

  Business response

  08/15/2022

  Attached I have a signed Financial/Consent to treat patients. We only **** insurance as a courtesy, all of our patients/parents are made aware that any amount that insurance doesn't cover is billed to them. Below are multiple attempts to reach MOC/Step-Dad by phone/Letter and via E-mail.  ***Also, the reason the balance went from $477.80 to $668.80 is due to multiple visits. I tried to get this figured out before they were seen again. The $477.80 is from 11/11/19 & 12/23/2019 visits. The remaining $191.00, is from 11/23/20 & 12/22/20. 

  - Wed - Aug 12, 2020 -I spoke with a REP from DDTX and they are asking the *** call ins to answer a few personal questions before they process the claim (who the patients lives with, if there is a court order etc.)I l/m for MOC to have her call me back. L/M for Stepdad too, he is the subscriber to DDTX. AN

  - Tue - Sep 15, 2020 - I left voicemail's for parents to call 2nd ins and provide the personal info they were looking for and waited a month. Parents never called ins. Per doctor we are to **** the family and they can proceed with 2nd ins. AN

  - Mon - Nov 23, 2020 -Spoke to MOC regarding balance and let her know that 2nd ins was asking personal questions before they would process the claims and pd zero. She asked if that was legal to ask and I said I'm unsure if it is or not but I think it's highly inappropriate. MOC stated that she is going to get to the bottom of it. AN

  - Wed - Dec 9, 2020 -MOC called back and stated that they wont talk to her since its Step-dad's policy. So she is doing a chat with them since they don't know its her. She stated that they pd and they have no portion due after that. I let her know that they have yet to pay and they do have a portion due of $477.80 before the 11/23/2020 appts. She let me know that she is going to continue to fight them and will follow up. AN

  - Wed - Feb 17, 2021 -Phone number not available, not able to l/m for MOC to follow up with 2nd ins. Sent MOC an e-mail (See Attachment above). AN

  - Wed - Mar 10, 2021 -L/M for Step FOC (DDTX Plan holder). Couldn't get ahold of ****** (MOC).AN

  - Wed - Mar 10, 2021 - Step FOC called back, he is going to call DDTX and call me back. Wanted to know what they have found out regarding 2nd ins. I don't want the acct to get too far gone and they have a huge **** in the end. AN

  - Wed - Sep 8, 2021 -Tried to call ****** and Step-dad's # and they both went straight to voicemail. AN

  Letter Sent to MOC on 9/16/2020: September 16, 2020
  
  Hello ******,
  
  This letter is to inform you that we have been unsuccessful getting both patients secondary insurance to process their claims from day of service 11/11/2019 and 12/23/2019, which is under Step-dad in our system.They are wanting personal information from Step-dad that we can't provide, before they will process the claims. I left a message for you and **** on 8/12/2020 stating they were looking for extra information. I followed up with them today to see if anyone has contacted them regarding these claims, and they said not as of now.
  At this time the balance of $477.80 is now due; Or if one of you could contact Delta Dental of ***** and provide the requested information regarding these claims by October 1, 2020 and have them reprocess those dates of service; I would be happy to re-**** you once they pay their portion. Otherwise,you will resume responsibility for the total balance of $477.80. 
  If you have any questions regarding the account, please feel free to contact us by phone *************, Monday-Wednesday from 8am-5pm or Thursday from 7am-3:30pm, or by E-mail:************************************
  
  
  
  Thank you,
  
  
  **********
  Business Manager

   

  Sent another Statement on 10/19/2021

  Another one with our standard warning letter on 11/18/2021:
  
  Dear ******,
  
  
  
  As you know your account is more than 90 days past due.  At this time your account balance is __$668.80____and is due.  Our records show that we have not received any payments from you since the services were performed.
  
  Perhaps you overlooked our ****. Todays parents are very busy people. Now that we have brought this to your attention, would you please send your payment in full today?
  
  Please call and speak to our office manager if you would like to discuss payment.
  She can work with you and help with a payment schedule that meets your needs.
  
  
  Sincerely,
  
  
  
  **************************, DDS, MS

   

  Sent our standard 30 days to collections letter on 1/25/2022:

  Dear ******,
  
  This is to inform you that your account in the amount of $___668.80____________is currently past due.
  
  We sent you a statement for the account on 9/16/20,10/19/21,11/18/21,1/25/022_, which was not acted upon by you. We request that you please submit your payment in full immediately.
  
  Your failure to pay the amount due on your account is a violation of the terms and conditions of our office policy agreement, a copy of which we have included with this letter. If you fail to pay the outstanding balance by _2/25/2022_, you risk having the account permanently closed.
  
  If you have any questions regarding the account, then please feel free to contact us by phone *************, Monday-Wednesday from 8am-5pm or Thursday from 7am-3:30pm, or by E-mail: ************************************
  
  We look forward to your timely response in this matter.
  
  Thank you,
  
  
  
  **************************, DDS, MS
  

   

  *Sent acct to collections 4/26/2022 due to no follow up/communication from MOC/Step-DAD.

  Business response

  08/16/2022

  Good morning,
  Per our telephone conversation a few moments ago, I am sending you the response that we have received. Please note, we also received 3 pdf attachments titled certified exit letter receipt, e mail and financial-consent.
  
  Please review and reply to this e mail with your updated response and we can enter the updated response manually.
  ------------------------------
  Attached I have a signed Financial/Consent to treat patients. We only **** insurance as a courtesy, all of our patients/parents are made aware that any amount that insurance doesn't cover is billed to them. Below are multiple attempts to reach MOC/Step-Dad by phone/Letter and via E-mail.  ***Also, the reason the balance went from $477.80 to $668.80 is due to multiple visits. I tried to get this figured out before they were seen again. The $477.80 is from 11/11/19 & 12/23/2019 visits. The remaining $191.00, is from 11/23/20 & 12/22/20. . I wanted to add the letter From Automated accounts showing the interest accrued by them. I sent in the total balance of $668.80 to collections the remaining $158.64 is accrued interest fees by ****************** (The ****************** we use). Please See attachment 
  - Wed - Aug 12, 2020 -I spoke with a REP from DDTX and they are asking the *** call ins to answer a few personal questions before they process the claim (who the patients lives with, if there is a court order etc.)I l/m for MOC to have her call me back. L/M for Stepdad too, he is the subscriber to DDTX. AN
  - Tue - Sep 15, 2020 - I left voicemail's for parents to call 2nd ins and provide the personal info they were looking for and waited a month. Parents never called ins. Per doctor we are to **** the family and they can proceed with 2nd ins. AN
  - Mon - Nov 23, 2020 -Spoke to MOC regarding balance and let her know that 2nd ins was asking personal questions before they would process the claims and pd zero. She asked if that was legal to ask and I said I'm unsure if it is or not but I think it's highly inappropriate. MOC stated that she is going to get to the bottom of it. AN
  - Wed - Dec 9, 2020 -MOC called back and stated that they wont talk to her since its Step-dad's policy. So she is doing a chat with them since they don't know its her. She stated that they pd and they have no portion due after that. I let her know that they have yet to pay and they do have a portion due of $477.80 before the 11/23/2020 appts. She let me know that she is going to continue to fight them and will follow up. AN
  - Wed - Feb 17, 2021 -Phone number not available, not able to l/m for MOC to follow up with 2nd ins. Sent MOC an e-mail (See Attachment above). AN
  - Wed - Mar 10, 2021 -L/M for Step FOC (DDTX Plan holder). Couldn't get ahold of ****** (MOC).AN
  - Wed - Mar 10, 2021 - Step FOC called back, he is going to call DDTX and call me back. Wanted to know what they have found out regarding 2nd ins. I don't want the acct to get too far gone and they have a huge **** in the end. AN
  - Wed - Sep 8, 2021 -Tried to call ****** and Step-dad's # and they both went straight to voicemail. AN
  Letter Sent to MOC on 9/16/2020: September 16, 2020
  
  Hello ******,
  
  This letter is to inform you that we have been unsuccessful getting both patients secondary insurance to process their claims from day of service 11/11/2019 and 12/23/2019, which is under Step-dad in our system. They are wanting personal information from Step-dad that we can't provide, before they will process the claims. I left a message for you and **** on 8/12/2020 stating they were looking for extra information. I followed up with them today to see if anyone has contacted them regarding these claims, and they said not as of now.
  At this time the balance of $477.80 is now due; Or if one of you could contact Delta Dental of ***** and provide the requested information regarding these claims by October 1, 2020 and have them reprocess those dates of service; I would be happy to re-**** you once they pay their portion. Otherwise, you will resume responsibility for the total balance of $477.80. 
  If you have any questions regarding the account, please feel free to contact us by phone *************, Monday-Wednesday from 8am-5pm or Thursday from 7am-3:30pm, or by E-mail: ************************************
  
  
  
  Thank you,
  
  
  **********
  Business Manager
   
  Sent another Statement on 10/19/2021
  Another one with our standard warning letter on 11/18/2021:
  
  Dear ******,
  
  
  
  As you know your account is more than 90 days past due.  At this time your account balance is __$668.80____and is due.  Our records show that we have not received any payments from you since the services were performed.
  
  Perhaps you overlooked our ****. Todays parents are very busy people.  Now that we have brought this to your attention, would you please send your payment in full today?
  
  Please call and speak to our office manager if you would like to discuss payment.
  She can work with you and help with a payment schedule that meets your needs.
  
  
  Sincerely,
  
  
  
  **************************, DDS, MS
   
  Sent our standard 30 days to collections letter on 1/25/2022:
  Dear ******,
  
  This is to inform you that your account in the amount of $___668.80____________ is currently past due.
  
  We sent you a statement for the account on 9/16/20,10/19/21,11/18/21,1/25/022_, which was not acted upon by you. We request that you please submit your payment in full immediately.
  
  Your failure to pay the amount due on your account is a violation of the terms and conditions of our office policy agreement, a copy of which we have included with this letter. If you fail to pay the outstanding balance by _2/25/2022_, you risk having the account permanently closed.
  
  If you have any questions regarding the account, then please feel free to contact us by phone *************, Monday-Wednesday from 8am-5pm or Thursday from 7am-3:30pm, or by E-mail: ************************************
  
  We look forward to your timely response in this matter.
  
  Thank you,
  
  
  
  **************************, DDS, MS
  

  Customer response

  08/16/2022

   
  Complaint: 17712187
  
  I am rejecting this response because: I will get legal advice moving forward. I also would like to add, as previously stated in my first message, that the entire **** was paid in full through the collection agency. I will not being paying the amount again with your office also. 
  
  Sincerely,
  
  ****** Click

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