Absolute scammers.
When I called them to make the appointment, my very first question was "Do you take [my insurance]?" She responded, "Yes, we do utilize that insurance" (I know the exact wording because I requested the phone recording and transcript from the office). She also said: "Okay, so normally with our visits without insurance, it's $154. We're going to do an exam and take an x ray to see what we can do for those teeth. But your insurance is going to cover, estimated cover that at 100%. So you won't have a copay for tomorrow. But if we do any treatment that same day, because we do offer a lot of same day treatment. So if we do anything tomorrow, we'll go over the prices with you before we do anything." I signed the typical new patient paperwork, which included a financial agreement, and signed a treatment plan that outlined the total cost and insurance insurance estimate.
A month later, I logged into my dental insurance, checked my claims, and saw that PDC is Out-of-Network. The exam also was not covered 100%. I called the office and asked why I wasn't informed that I was Out-of-Network. The woman insisted that I was informed because she was the person I spoke to and she informs everyone when they are Out-of-Network. (The phone transcripts have now proven that false). She offered to file an appeal on the insurance claim to see if we can get more covered on essential procedures.
Maybe a week or two later, I get a text from the office saying "It looks like insurance paid less than we had estimated, leaving your account with a balance. How would you like to handle this?" I checked with my insurance, they never received an appeal. I called the office and informed them of this and the assistant insisted that she filed the appeal. I get on a 3-way-call with the dental office, myself, and my insurance. Suddenly, my insurance says an appeal has been received, dated for the same day. The assistant also says she's going to send a paper copy in the mail and emails me a copy of the appeal.
A month and a half later, I received another text "Your insurance denied the first appeal....We went ahead and send[sic] another appeal to fight again. Hopefully this works but we can only send two appeals." A few days later, I received a full bill in the mail, dated the next business day from when I received the text about the second appeal. It was already marked 90 days past due because the procedure was more than 90 days ago despite this being my first time seeing a bill since we were fighting with the insurance.
I received another text from a new assistant informing me of my outstanding balance shortly after. I replied and asked about the second insurance appeal that the previous assistant had stated they sent and asked why I was receiving a bill if we were waiting to hear back from my insurance. I never received a reply.
Life got busy, I'll admit I forgot about it, but then not even a month later I started getting texts from a debt collector. The dental office had sent my balance to debt collection. I called the office to once again inquire about the second insurance appeal and to discuss the previous issues I had experienced. They said nothing about the appeal and basically waved their hands because the balance was now out of their hands since it had been sent to the debt collector. It was during this phone call, that I requested the recording and transcript of my first phone call for proof that I was not informed that I am Out-of-Network.
They emailed me the recording and transcripts along with my signed financial agreement and treatment plan. The unnamed sender (because they simply signed it as the Dental Team) apologized for MY confusion and started citing policy: "The "estimated insurance" portion is always just an estimate. The full fee is your responsibility regardless of what insurance pays.....Our financial policy remains in effect. We understand that this situation has been challenging, however we have to work within the framework of our policies."
I paid the debt collector but then I got another message from the dental office with ANOTHER outstanding balance. I called asking what it could be because I paid the debt collector. Interest.
Had I known they were Out-of-Network, I never would have used their services. I know the prices on the treatment plan were estimates, but I never would have imagined In-Network dental procedures being denied and then having to pay virtually the entire amount. Then they slapped "90 days past due" on the first bill I received and turned it over to a debt collector in order to collect interest and other fees.
Be very careful with these people. They lie every chance they get. Read all of the fine print. They will milk you for every cent you've got and leave you in worse pain than you went in with. read more
