Perfect Teeth

Initial Business Response / [redacted] (1000, 8, 2015/09/04) */ This letter in response to case #XXXXXXXXIn order to protect our patient's health information as outlined by HIPAA, we have responded directly to the patient via [redacted] addressing her concerns and offering her a second opinion Initial Consumer Rebuttal / [redacted] (4200, 15, 2015/09/30) */ I never received any mail communication from Perfect Teeth Final Business Response / [redacted] (4000, 21, 2015/10/30) */ This correspondence is in response to the Revdex.com complaint filed July 23, I would first like to apologize for any and all miscommunications between our dental offices and yourself On July 31, you were seen at Perfect Teeth on Speer Blvd to have a crown from a previous visit seated and have a comprehensive oral evaluation and full mouth series of radiographsAt that time it was noted that you had not had radiographs or a cleaning in over a yearIt was documented by the hygienist that there was moderate plaque buildup and moderate bleeding on probing, especially in the molar areasOral irrigation with .12% chlorohexidine, Arestin on tooth #18, as well as fluoride varnish was recommended in conjunction with your cleaning and oral hygiene instructions explaining gingivitis, periodontal disease, decay process and etiology were also given at that timeDuring your evaluation with [redacted] , surface resin restorations were recommended on teeth # 13, 14, 12, 3, and 4, as well as crowns being recommended for teeth #and #You returned to the office on August 14, to have your cleaning, oral irrigation, Arestin, and fluoride varnish completed with the hygienistOn October 6, you returned to the office to start your restorative treatment with [redacted] , and at that time informed her that your bonded retainer felt loose and that tooth #had moved since your cleaning being completed in August [redacted] notated that she would contact the manager on your behalf to help resolve the situation On December 10, 2014, you were seen by Dr [redacted] at the Buckley Perfect Teeth and expressed your concerns with a space that had opened up between teeth # and #8, with tooth #being flared forwardAt that time the option of limited upper orthodontic treatment for 3-months with the use of traditional metal braces was recommended to improve the position of tooth #and close the space between teeth #and #8, with a new bonded retainer being placed upon completion of treatment to help prevent the space from re-openingHilary at the Buckley location talked to corporate on your behalf and the recommended treatment was to be performed at no cost to youYou agreed to the proposed treatment plan and scheduled to begin treatment on January 14, at [redacted] 's new office Perfect Teeth on MonacoOn January 14, 2015, after treatment consents were signed, you had limited brackets placed on your upper teeth On May 6, 2015, you were seen to have your braces removed and a new bonded retainer placedIt is notated in your chart that at that time [redacted] asked you if you were satisfied with the esthetics; you stated you were which is why the braces were removed at that timeThe bonded retainer was larger than the one you had previously to provide more support and lessen the chances of tooth movement after the braces were removedAfter having the braces removed, you informed [redacted] that you were unhappy with the positioning of tooth #7, which appeared to be slightly flared forwardA radiograph was taken which showed that due to the angle of the crown of the tooth in relation to the angle of the root, the tooth does not line up completely straight with the other teethIn order for the tooth to align perfectly, the root of the tooth would touch the root of the adjacent tooth, which may cause further dental issues [redacted] gave you the best options in his professional opinion regarding the movement of tooth #and the risks and benefits for each option, and offered each option at no additional cost to youAs well, you were concerned about white spots on your teeth which appeared after having the braces removedOn occasion, there is decalcification associated with orthodontic treatment, which causes discoloration of the teethWhile good oral hygiene helps prevent this from occurring, it is a risk of treatmentThis was explained on the consent form signed by you in our office on January 14, prior to treatment being rendered While we strive to provide excellent dental care to our patients, orthodontic treatment is not an exact science, and circumstances outside of our control can affect the outcome of treatmentWe understand your concerns, and would like to offer you a second opinion with another one of our Perfect Teeth orthodontists Again, I apologize for any miscommunication between our offices and yourself

I called and spoke with [redacted] today and we reviewed the information she was concerned aboutWe came to an agreement about the outstanding balance and resolved any issues with itI apologized for not getting back to her in a timely manner and told her I would address this with the staff as this is not the customer service we want to deliver

Good MorningWe have reviewed the complaint from [redacted] and we are unable to locate her in our networkWe would love to respond if she can provide us with the Perfect Teeth office where she saw the DentistIf it was a perfect teeth we apologize for any pressure put on her as this is not how we conduct our business

A denial letter was received from Delta Dental Tricare on October 4th stating that patient was not eligible on date of service September 28, The operations manager double checked the coverage and corrected any errors on the claim and re submitted the claimOur A/R team did make an error and requested the letter per our company policy but didn't acknowledge the notes regarding the claim being re submittedThe account has received the payment from Delta Dental Tricare and now has a zero balance We will talk with our Accounts receivable team to ensure that this doesn’t happen againWe are sorry for the inconvenience this has caused and value you as patient in our office

Complaint: [redacted] I am rejecting this response because:This is not an acceptable response to meI have spoken to Perfect Teeth on several occassions due to me calling and following up with themThey always promise to call me back but never doI have been told that they have been reviewing my claim for the past plus months with no resolutionSo, the response that they are re-reviewing this is just absurd and will adjust if needed.I am not responsible for this payment and will not pay for this due to their lack of timely filing on their partIf I have to take this matter publicly, I will do that Sincerely, [redacted]

Ms [redacted] I apologize for the confusionWe quote the patient the best we can with information provided to usThere are many insurance plans where the same plan will have a little change to it and can be sometimes very difficult to verify for usyour plan with in a plan has a waiting period which we did not identify with the information provided to usIt is always helpful when the patient knows the plan limitations because we can get many different answers when verifying due to the many different changes in the same plansPlease feel free to call meDonna Brandenburger ###-###-####

Revdex.com: I have reviewed the response made by the business in reference to complaint ID 11031901, and find that this resolution is satisfactory to me Sincerely, [redacted] ***

We contacted Ms*** today January 26,and requested that we split the balance on her account with herMs [redacted] agreed to this solution and will pay her portion We would like to apologize for the misunderstanding we had with her insurance policyThank you Ms [redacted] for being a patient of ours, we appreciate you very much

Initial Business Response / [redacted] (1000, 6, 2015/11/03) */ Ms***, First, we sincerely apologize for the inconvenience this has been for youAfter reviewing your account and the explanation of benefits, we have found that we owe you an additional refund from your December date of serviceThe refund should be processed by the end of the weekTo avoid this mistake again, we definitely will pay more attention to detail and stay in contact with our patients every step of the wayAgain, we apologize and thank you for bringing the issue to our attentionIf you have any further questions or concerns, please feel free to contact the Operations Manager, [redacted] , at (XXX) XXX-XXXX

In regards to consumer complaint # [redacted] We apologize for any miscommunication received while in the officeWe strive to give patients the Gold Standard and are disheartened to hear about your experienceAs a courtesy, we give estimates based on the current plan information we have on fileIn an effort to ensure we have the time to give the care needed we schedule longer appointment times, especially if the severity of the case requires it.Insurance billing upon seat date is often required by the insurance company and is sometimes delayed due to the nature of the restorationTo maintain privacy and adhere to HIPPA regulations we are unable to discuss any further detail as this is a public forumA separate letter will follow by mail

I apologize that we have not been able to meet the need of your requestWe stand firm behind our decision to require payment for services rendered by our providers You have a contractual obligation between you and your insurance to pay for treatment receivedWe normally require payment upon date of service as outlined in our office policy, signed at your initial appointmentAs a courtesy, we billed your insurance prior to collecting your patient portion to correctly address the discrepancies from the previous quoteWe strive to be as accurate with our quotes as possible, but sometimes pricing does change due to circumstances out of our controlFor the sake of transparency and full disclosure to our patients, we would rather quote high and have a patient be pleased with the savings, rather than quote low and surprise someone with a larger bill than anticipatedThe final pricing is contractually set by insurance coverage, and we are not legally able to dictate what an insurance company’s final coverage will be regarding a patient’s treatment

We are responding to the question regarding the DOS 7-28-on [redacted] for a crown on Tooth Patient has an HMO primary through [redacted] which denied the claim and did not pay anythingHad the patient had only [redacted] and no secondary insurance, the patient would have had an out of pocket expense of $(the copayment under the HMO plan) We submitted the claim to [redacted] secondary insurance carrier [redacted] Our UCR was $1314, but our agreed upon HMO charges were $ According to [redacted] , they actually allowed $due to the patient's election to have a porcelain upgrade However, we gave the patient the greater benefit and only charged him for the $for the crown - the lower HMO fee [redacted] paid $(50% of their covered expense) THe patient was responsible for the remaining balance of $($545-$332.50), of which the patient paid $in cash on 9/3/Therefore, the patient still owes an additional $on the crown, because there was a patient co-insuranceThere was a cent late charge on the account, so the total amount turned to collection was $ The attached EOB clearly shows a 50% benefit, so the patient has a coinsurance responsibility Where I think there is confusion is that even though [redacted] primary may have told him they paid everything - they actually paid ZERO 100% of the contract rate of $was due from the patient The secondary, [redacted] , actually helped in defraying some of that expense by paying $ However, we are entitled to collect up to the contract rate under the lower plan; therefore even after the secondary payment, the patient had a balance dueWe hope that this clears up the confusion It is a common misconception that when a patient has both primary and secondary insurance that there are no out of pocket expenses, which isn't always the caseTypically the secondary helps defray a part of the patient's coinsurance, which was the case in this instance If you have any questions, please contact the Regional Director of Operations - [redacted] at [redacted]

Great and competent staff [redacted] is great!

To whom it may concern,Our Regional Director, *** ***, spoke with *** on Friday September 15th regarding her dispute*** asked that *** give until Thursday September 21st to review the case with the office manager to determine the amount of refund that would be owed to the patient
for incomplete treatment that has been brought to our attentionOnce this has been determined today, we will promptly call her back by 2:pm with the refund amount. Thank you,

Complaint: ***
I am rejecting this response because:
Sincerely,
*** *** I do not agree there payment agreements and here is there website and pricing. Greg *** ToKrystal Brittelle Greg ***May at 5:12 PMKrystal, I appreciate your reply but one question that I have since I purchased the perfect teeth plan looking over the cost for the dentures I was billed $for both the upper and lower dentures 10/5/but looking over the perfect teeth website the cost listed $(upper) and $(lower) so there needs to be a adjustment for the pricing on that bill which is a $(upper) and $(lower) total $ 845.00 http://www.perfectteeth.com/dental-plans/details/(2)Could you please make the adjustment on this along with the current payments I've made ? Thank You G***

Tell us why hereWe have been in communication with the patient and we are in process of collecting all signed estimates, signed care credit receipts and Explain of benefits from his insurance carrier. Both accounts have been pulled from collectionsOnce *** has received the copies off all signed documentation we will be in contact again to discuss and come up with a reasonable agreement between both parties

Complaint: ***
I am rejecting this response because:I have a broken tooth due to your negligence
Sincerely,
*** ***

Mr*** I apologize for your frustrationWe should have explained it better than we didYou have periodontal disease in one portion of your mouth that requires more that a standard cleaning to correctWe offered to provide a cleaning for you in all areas where a standard cleaning would provide
effective care for youWe also offered to polish the area where you have periodontal diseaseWe would have misled you into thinking that we were providing accurate care to the area where extensive below the gum disease existsA covered cleaning in that area does not provide the ability to clear up the infection you have and may result in the loss of bone or teeth from infectionWe are not trying to deceive you but instead trying to help you in understanding that you have a disease that needs further careYou are correct that we can not require you to complete the service but we are required to inform you of our findings and what we can do to eliminate the infectionAgain I apologize for your frustration with the situation and hope you are able to have a better understanding of the situation you present withDonna B***

Good morning Mr***, Thank you for taking the time to provide me with your new treatment plan from *** ***After carefully reviewing our x-rays and the treatment plan from *** *** in great detail, we cannot find evidence of your claims regarding the treatment
performed by our providerIn fact, your new treatment plan is almost identical to the treatment plan that was outlined by our provider, *** ***, back in January of While we sympathize with your frustration, we cannot find substantiated evidence in the information you have provided to provide you with any further compensation Again, thank you for giving us the opportunity to review your claims and we wish you the best of luck with your future dental careSincerely,*** ** *** *** *** *** *** ***

Initial Business Response /* (1000, 7, 2015/10/21) */
Thank you for talking todayI am glad that we could find a solution to eliminate your issuesI have put into place every resolution we discussed todayThank you for giving me the chance to provide the assistance you neededPlease feel free
to contact me if any further issues arise