I have pondered upon whether to disclose this for the past three months but it has become apparent to me that the people who own and run this clinic simply do not have any integrity, I have experienced a very disheartening but an eye-opening lesson to me and I hope that by my sharing it will serve as a precautionary message to anyone who intends to patronize this business.
I chipped my teeth in mid-May and called this dental office and enquired if they accept my dental insurance plan as I wanted to have it looked at, to which they enthusiastically said "YES" and will call me back after they have verified my information and the insurance plan.
They called me back later in the day and told me that they have verified everything and that they do accept my dental insurance plan to which I felt at ease because I wanted to be 100% certain that their services would be covered under my insurance plan. I was curious about their charges and took due diligence to ask how much it would cost to have my chipped teeth looked at and "repaired". I was assured that I would be informed after seeing the dentist the next day and the cost will be determined there and then pending my agreement before any services would be rendered.
I went in the next day as scheduled and was seated before having my x-rays taken followed by an inspection by the dentist that recommended having its surface filled with resin. I specifically enquired about the charges and they assured me that the x-rays were covered under my dental insurance plan and that my out of pocket charges would be for the resin filling which amounted to $82.80. I agreed to the charges and when I submitted my payment there was also a printout generated from their system that explicitly stated the breakdown consisting of the amount covered by my insurance and the amount that I had to pay which was $82.80.
Two weeks later I received a statement from my insurance company notifying me that they were paying only $75.80 out of the dentist's claims of $329 from them. I called and enquired and was told that the dentist's charges were not considered normal based on what other dentists in the area were charging for the same service. I was perplexed, I proceeded to call the dental office and addressed with the dentist's wife , Jo Beth, to find out if indeed there was a discrepancy or misunderstanding based on what I was told were my charges during my visit to the dentist.
The dentist's wife, Jo Beth, stated that they don't always know the exact amount until after they have filed a claim with the insurance company. So I told them that as a consumer I could only rely upon their diligence in their quote for the service required. Besides, it is only reasonable to be under the impression that the price that was quoted to me should be final and not variable unless being told otherwise.
Moreover, they have full access and knowledge of how much they will be reimbursed by the insurance company assuming that they have verified this with the insurance company before presenting me with a quote! If any point if they were unsure, it is their duty and due diligence to check with the insurance company. It is unethical to shift the burden to me for their own negligence and unprofessionalism! It is all the more ludicrous when she defended themselves shamelessly by revealing to me during that conversation that it became evident to her when she looked into the system at my urging that there is in fact another tier of calculations or billing guidelines that was in place. This obviously meant that they did not check the billing guidelines diligently and as a result misrepresented the service charges to me.
I was empathetic despite their lack of accountability as I always believe in being fair and finding a win-win situation for all. Thus, I proposed to her that for the remaining $170.40 that they failed to get a reimbursement from my insurance company as a result of the aforementioned reasons, I was willing to pay half of that which is an additional $85.20 considering that they have already received payment of $158.60 from what I paid them during my visit and what the insurance has reimbursed them.
To my grave disappointment, she refused and kept defending their stance without any remorse or taking responsibility for their mistakes.
How can a business conduct itself in such an unscrupulous manner without integrity?
How can a business behave so dishonestly even after it has accepted payment from its client that was mutually agreed upon at the time of service without any inference that the client will incur additional charges thereafter?
Is this not a fraudulent misrepresentation of charges or an unconscionable and unethical business practise ? To state that I am gravely disappointed is an understatement, this has been a violation of trust and shows a lack of integrity. Integrity is the core bedrock value that has proven to be a constant in our dealings with others but do not expect this from them. read more
