I do not recommend this practice due to the billing issues I have experienced.
I had a cleaning on March 24th, during which it was determined that I needed three crowns. At the time, my insurance was set to end on March 30th, and I specifically wanted to complete the crowns before that date so they would be covered under my existing plan. I was moving to a new dental play April 1st and would use that plan for any additional work I needed. Javon advised me that my current plan paid well and that it would be beneficial to proceed with all three crowns.
I was given an estimated out-of-pocket cost of $2,100, which was set up on a three-payment plan. However, while I was shown a treatment plan to sign, I was never provided a copy at that time.
On March 30th, I had all three crowns completed and paid the first installment of $733. The remaining payments were scheduled for May 15th and June 15th. I was told to return in three weeks for the permanent crowns. I also requested a breakdown of charges, but the statement I received was unclear and did not distinguish between insurance payments and my responsibility.
Before my follow-up appointment, I received Explanation of Benefits (EOBs) from United Healthcare indicating that Prairie Star was out-of-network and that two of the crowns were not covered. I immediately contacted Javon, who assured me they would honor in-network rates and that she would follow up with United Healthcare regarding the uncovered crowns. I asked her to keep me informed.
I returned on April 21st to have the permanent crowns placed.
On May 1st, my card was charged $733, which was not the agreed-upon date. I called and left a message, and Javon returned my call on May 5th. She stated that payments were set for the 1st, which was not what we had agreed upon. I also asked for clarification on what I was being charged, as I still had not received a clear explanation.
At that point, she referenced the signed treatment plan, which I had never been given. She then emailed it to me, and I discovered that my insurance did not cover the third crown because the max had been met. I was charged over $1,300 out of pocket for that crown without this ever being clearly communicated to me beforehand.
Additionally, she sent an updated payment plan totaling $2,900, which was not what I had agreed to. It did not reflect the initial payment I had already made and included an additional payment that had not been discussed.
Had I known that one of the crowns would not be covered, I would not have rushed to complete the procedure before my insurance ended. That was the entire reason for scheduling the work on March 30th. I was also informed that no pre-certification was done due to time constraints, which was never disclosed to me prior to treatment.
In my experience, dental procedures are typically accompanied by clear communication regarding insurance coverage and patient responsibility. In this case, that did not happen. There were multiple opportunities during appointments and phone calls to inform me that I would be responsible for the full cost of a crown, but this was not communicated.
Furthermore, I have now been told that if the second crown is also not covered, I may be billed for that as well.
The Office Administrator plays a critical role in communicating with patients and coordinating with insurance. A lack of transparency and the introduction of unexpected charges after the fact is unacceptable.
For these reasons, I cannot recommend this office.
I've asked to speak personally with Dr Rawcliffe and I hope he responds because he is a good dentist and should know the billing nightmare happening at the front office. I was a patient of his a few years ago and did not experience these types of issues at that time. read more
