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The Art of Modern Dentistry ANOTHER VICTIM CHICAGO, Illinois
Beyond frustration since I've been referred to 4 different people (Sandra, Lisa, Tina, Josephine)since this process started and all have chosen to run from this issue and not return calls. I've now resorted to filing a complaint with the BBB and now Ripoff Report. I wonder how many others are out there with the same issues from this place?? Is is true that she is under investigation for insurance fraud with Delta Dental??
2 Updates & Rebuttals
JMD
HOMEWOOD,Illinois,
Response
#3Author of original report
Mon, April 22, 2013
Tina, it is amazing that you can respond to a blog, but you can't respond to me directly. I didn't use my name because I wanted to see first if anyone even would respond, but you will notice my name at the closing of this.
First and foremost, I didn't accuse your office of "fraud", but merely asked if that claim of fraud that was stated by the other complaint against your business was in any way true. Since you know who I am, then you should know that I do not have Delta Dental insurance...my carrier is Sun Life...the carrier that brought me to send my daughter to your office in the first place since Dr. Daftary's name and phone number were listed there as an in network dentist. I was told she would honor in network fees before the services were even started (no mention of her severance of her network status even came up until after the services were completed in January.)
You yourself said in an email that she honors in-network fees. Your office even filed the claims using those in-network fees and were reimbursed by Sun Life at an in-network rate of 50% vs. 40%. Sun Life also made the determination in February of not going back and getting the 10% overpayment and at the same time processed the remaining unpaid claim as out-of-network at 40%.
When I spoke with Joseline on March 15th, she requested that I send her everything, which I did. I waited a couple of weeks before contacting her again and never could get a return call. Then I get an email from her on April 3rd that stated a $193.70 credit was applied to the Care Credit account, which I replied back asking her for an explanation and a breakdown of the services. I understand when this Care Credit was established, it was initially going to be for the Invisalign, but other circumstances prevented from that part of the treatment even moving forward.
During the course of all these services, I never one received a statement in the mail and all I had to go by were the explanation of benefits I was receiving from Sun Life. When I got a phone call the evening before what was to be Danielle's Invisalign appt. stating that she couldn't be seen unless I paid the fees up front, that's when this whole can of worms opened up and I received a statement via email that evening of the charges on the account, which weren't related at all to what the claims were filed as.
As far as your office trying to explain the situation.....one person would start to explain and then say they had to look into it and then they would get back to me. Then I would wait for a response and get another person on the phone who again was going to look into it. First it was Sandra, then it was Lisa, then I finally got you involved as the office manager because I wasn't getting any feedback from Sandra or Lisa. You said I had to wait for Sun Life to finish processing the claims, which were done in February.
Then I hear nothing again and get Joseline on the phone who said she has now taken over this for your office and who I sent the Sun Life information to along with your email response and again, nothing. Then no one will return my call but I get a $193.70 credit with absolutely no explanation of what exactly the credit is for....so I called back Joseline and emailed her asking for an explanation of the account but no return call. Actually I was originally told by Sandra that a credit could never be processed through Care Credit, so once again, more miscommunication. That's when I called Care Credit because if I couldn't get an explanation from your office, then maybe they could.
And, that's what also brought me to here and the BBB. I am 53 yrs old and have never had a billing issue with a dentist or doctor in my lifetime for either myself or my children until now. I also am not an unreasonable person and have just tried to work with your office...unfortunately the favor hasn't been returned. So what exactly are you waiting on now from my end that is keeping you from being able to continue??? Bottom line is that you already received $3000 from a Care Credit account and $1581.36 from my insurance company for services that totalled $3594.17. You have my contact information so you shouldn't need to resort to this blog to resolve these issues, but if this is the route you prefer to take, then so be it. The ball is now back in your court!
June D****
Tina
Chicago,Illinois,
AMD Response
#3UPDATE Employee
Fri, April 19, 2013
To clear up any questions or statements regarding Art of Modern Dentistry and whether or not the office or the doctors are under investigation for anything. They are not. The previous post is a disgruntled patient that is now in collections for a balance. So the "postings" stating so are indeed false. Patients do not post their name but I am able to identify who they are based on the posting. We can only resolve issues to a certain point. I am unsure why patients or their guardians feel a doctor should not be compensated for the work they have preformed on a patient. Whether or not the insurance covers a procedure is between the patient and the insurance company not the dental office. Regardless of what is paid by insurance the balance belongs to the patient.
Be careful when you use the word "fraud" it can get you in to trouble if you can not factually back that up. As for Delta Dental since you specified them, please feel free to call them and verify that the office or any of the doctors practicing here are not under any type of investigation whatsoever.
As far as any of the mentioned people running from your specific issue, that is not the case. We have tried to explain the situation more then a few times regarding your daughters treatment and payment. As stated in response to your BBB complaint since you have charged back the payment for the services rendered to your daughter we are unable to continue until this is resolved. If the charge back is successful the balance will become your daughters.