Dr. Lippiner was recommended to me by my dentist to perform a tooth extraction and an implant.
He was knowledgeable and conscientious as he carefully explained the procedures. There was no pain and his treatment was gentle with only minor discomfort from the extraction. As far as I can tell, the work was well done and would be deserving of a good rating. However, his billing practices were another matter.
As a member of the MetLife Dental Network, Dr Lippiner had agreed to charge fees at the MetLife Negotiated Rates. In December 2013, he extracted my tooth and I paid him $1,154. The Explanation of Benefits from MetLife later showed that after the benefits were paid by MetLife, my responsibility to Dr Lippiner would be $964. So, apparently, I had a credit of $190.
Therefore when work on the implant started in August 2014, I was surprised that he charged me an additional $539. His reason was that the insurance covered the surgery but not the materials used in the surgery, so the materials should be charged additionally.
I then reviewed the Explanation Of Benefits from MetLife. It explicitly stated that the fee for the surgery DID include the cost of the materials which should not be separately billed. Therefore I was being double-billed for the cost of the materials. Just to make sure, I called MetLife and a customer service consultant confirmed my understanding that the cost of the materials was included in the fee for the surgery.
The next day, I called Dr. Lippiner's office, explained my research, and asked for a refund because the cost of materials was already included in the fee, as agreed between Dr. Lippiner and MetLife. The bookkeeper ignored my request, repeated that the insurance did not cover the materials and stated emphatically that every item in the ledger account was justified and billed at the negotiated rates.
I could see that this was definitively not the case because as she was speaking on the phone, I was holding in front of me both the ledger account and the MetLife Explanation of Benefits. The fees they charged for each item bore no relation to the negotiated rates. In the Explanation of Benefits, the MetLife Negotiated Fee for the materials was $0 because the materials were already included in the fee for the surgery. So this was clearly a double billing.
At this point, I realized that I was being given a run around and there was not much point in arguing the facts. Over the nine months that followed, I raised the question verbally several times and twice in writing, but Dr. Lippiner never even tried to address my concerns. It would have been easy for him to check with MetLife had he chosen to do so, but each time when I raised the question, he just repeated that the materials are not covered by the insurance (and so should be charged additionally). Apparently he expected me to accept this simply because he asserted it, even though I had a paper from MetLife stating that this was not the case.
In March 2015, I submitted a grievance to MetLife and asked them to perform an independent review of the fees he had charged. One month later, the result of the review was mailed to Dr. Lippiner showing that I was due a refund of $528. After six weeks (and a second reminder), I received a check for $528. About ten months had passed since I first realized that something was wrong.
To be fair, I would give Dr. Lippiner a good rating for his work alone. However, it is not enough for a dentist to do good work: the patient should also feel comfortable that the dentist is following the agreed financial arrangements.
So I could never recommend him to anyone else because although I did eventually receive what was owed to me, I found that Dr Lippiner's billing practices and his refusal to address my concerns were both totally unacceptable. read more
