Thousand Oaks Dental Group

Customer service is important to Thousand Oaks Dental Group and a principal part of our commitment to customer service we make every effort to accurately estimate co-insurance for each patient
According to our records the treating doctor is a participating
provider with MsMarlow’s insurance carrierUnfortunately, MsMarlow’s insurance carrier has paid her claims as out-of-network services resulting in an overpayment to our officeWe are in the process of getting the treating doctor’s contract status corrected with her insurance carrierOnce this has been accomplished, a refund to the Plan will be issued accordingly
However, MsMarlow has been appropriately charged in-network fees for the services we provided to herUnfortunately, a payment has not been made on this account since March 14, by MsMarlow and/or any responsible partyOur attempts to obtain payment have been unsuccessful, as such, the account has been sent to collections for her balance
In closing, MsMarlow has been appropriately charged for all services renderedA refund to the patient of the overpaid amount by the insurance carrier is not appropriateUpon receipt of payment in full of MsMarlow’s outstanding balance her account will be removed from collections
Respectfully,
Thousand Oaks Dental Group

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID 10185197, and find that this resolution is satisfactory to me. 
Thousand Oaks Dental is forgiven for not knowing the doctor fell out of our network. The collection agency was paid in full.   
It may behoove Thousand Oaks Dental to know it is good business practice to let customers know when doctors change networks, even if the networks are within the same insurance company. Cigna's records show the doctor was updated to the Radius network January 28, 2014, which is a division of Cigna, but still out of our network. According to Cigna, the doctor fell out of our network on September 30th, 2013. 
Regards,
[redacted]

As stated by the Business.
 
Thousand Oak Dental Group has confirmed that the treating doctor was in fact a contracted          
provide at the time of the Customer’s  visit. As such, we have contacted the insurance carrier
to have the claim in questioned re-processed. Once this has been completed we will issue the
appropriate refund to  the carrier.
 
However we would like to reiterate the Customer has been appropriately charges in – network
Fees for the services we provided to her. We anticipate the re-processing of this claim will
not impact the patient’s financial responsibility.
 
In closing, once the claim has been correctly re-processed by the Customer’s   insurance carrier
We will issue the appropriate refund to the carrier as the Customer   has appropriately charged
for all services rendered.
 
Respectfully,
Thousand Oaks Dental Group

Review: TO Dental would not correct our bill in a timely manner. They are still working on fixing the error made after 6 months. Meanwhile, they sent our account to a collection agency.It seems they billed the insurance as out-out-network. The result was about double the estimate we got as in-network. So, the maximum was reached leaving us with no more insurance for the year.Desired Settlement: TO Dental should give a full refund. When they are able to get back in-network and submit a proper bill, they can collect.

Business

Response:

Customer service is important to Thousand Oaks Dental Group and a principal part of our commitment to customer service we make every effort to accurately estimate co-insurance for each patient.

According to our records the treating doctor is a participating provider with Ms. Marlow’s insurance carrier. Unfortunately, Ms. Marlow’s insurance carrier has paid her claims as out-of-network services resulting in an overpayment to our office. We are in the process of getting the treating doctor’s contract status corrected with her insurance carrier. Once this has been accomplished, a refund to the Plan will be issued accordingly.

However, Ms. Marlow has been appropriately charged in-network fees for the services we provided to her. Unfortunately, a payment has not been made on this account since March 14, 2014 by Ms. Marlow and/or any responsible party. Our attempts to obtain payment have been unsuccessful, as such, the account has been sent to collections for her balance.

In closing, Ms. Marlow has been appropriately charged for all services rendered. A refund to the patient of the overpaid amount by the insurance carrier is not appropriate. Upon receipt of payment in full of Ms. Marlow’s outstanding balance her account will be removed from collections.

Respectfully,

Thousand Oaks Dental Group

Business

Response:

As stated by the Business.

Thousand Oak Dental Group has confirmed that the treating doctor was in fact a contracted

provide at the time of the Customer’s visit. As such, we have contacted the insurance carrier

to have the claim in questioned re-processed. Once this has been completed we will issue the

appropriate refund to the carrier.

However we would like to reiterate the Customer has been appropriately charges in – network

Fees for the services we provided to her. We anticipate the re-processing of this claim will

not impact the patient’s financial responsibility.

In closing, once the claim has been correctly re-processed by the Customer’s insurance carrier

We will issue the appropriate refund to the carrier as the Customer has appropriately charged

for all services rendered.

Respectfully,

Thousand Oaks Dental Group

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID 10185197, and find that this resolution is satisfactory to me.