Complaint Review: Forward Dental Delafield - Delafield Wisconsin

This report doesn't surprise me.  In the couple of years since my dentist moved/sold his practice to Forward Dental, my billing has been very confusing.  I've had multiple unexplained billing additions and subtractions by Forward Dental. 

They tell me at the counter before and after my visits that they know the exact charges and even make me sign a "treatment plan," in the dental chair.  This "plan" is really just an agreement to pay a specific amount, which they usually require me to pay before I leave the building.  Often I later get a credit or an additional charge on my account--much like the second visit charge you incurred for closing the tooth after a root canal.  These charges are completely unexplained, and none of the several receptionists I've spoken with has any additional info other than that her computer shows the charge. 

One time I came in for an emergency visit and was forced to pay $147 from a previous visit before I could get treated.  The previous visit was supposed to have been covered by my insurance and my previous payment-in-full.  I was hopped up on Vicodin at the time, but I still talked with the receptionist for quite awhile trying to figure out where that charge had come from given as I'd paid my previous bill in full.  She had no information and couldn't even point me to someone who could explain it.  I needed the emergency service or I would have walked out and left the appointment hanging pending resolution of this amount.  The next time I came in, a different receptionist told me I was overpaid and had a credit, but of a smaller amount.  I still don't know why the extra charge was imposed.

I have a strong feeling (but can't prove because of lack of detail billing) that Forward Dental is ripping me and my insurance company off on these charges.  One of my theories is that they bill what is reasonable and customary on the first visit, and then research what insurance will pay with a PA (prior authorization) before they bill insurance for the charge.  If insurance will pay more, they bill for the max amount the insurance will pay, which then raises the percentage the patient has to pay.  (For example, if they charge $500 for the first visit and expect insurance coverage of 80%, they take payment from the patient for 20% of that, or $100, on the first visit.  If they then file a PA and discover insurance expects a charge as high as $800, they send a bill for $800 to the insurance company, which pays $640 instead of the $400 they would have settled for initially.  But now the patient owes an additional $60, or 20% of the additional $300 they billed the insurance.  They then adjust the patient's account by $60 and insist the patient pay this additional amount on his/her next visit.  But that's just a theory of mine.)

In any event, I'm sure they are playing games with the numbers after I actually leave the office--my "paid in full" payment is never the end of it.

My advice is to leave Forward Dental--even if you like your dentist.  It's just not worth getting ripped off with all this bait-and-switch confusion.  And my belief is that any dentist that will work with these con artists either has integrity problems of her/his own or just doesn't care that much about the patient (or both!).  (Check the individual BBB reports for all the Forward Dental offices in the Milwaukee area--many of them have terrible BBB ratings which they haven't even tried to rectify.)  There are plenty of other dental outfits a dentist can work for that are honest, even if s/he doesn't want to set up an independent practice.

If you have to stay with Forward Dental for some reason, insist on receiving a receipt that states "PAID IN FULL" each time you visit and pay.  When presented with a treatment plan and an amount ask how much of that amount covers that particular visit, and insist on paying only for that portion of the overall charge, again getting a receipt that says "PAID IN FULL" before you leave the building.  Also ask how much the next visit(s) will cost before treatment.  If the price varies tell them you will go to a different dentist for the conclusion of the procedure unless they honor the original price.  What is crucial through all of this is to keep every piece of paper (treatment plans, receipts, etc) and bring it all with you on every visit.  That may not prevent what is happening to you, but at least you'll know where they cheated you. 

I would also not shy from disputing credit card charges after the fact.  When you're in the office you can be considered to be paying under duress, so the card receipt you sign may not be enforceable.  The credit card company can then help you sort out what happened and what you truly owe under agreement.

What's ironic is that my dentist has always been against more regulation of the dental industry.  He and I have talked about this many times over 20 years and I've agreed with him up until now.  But now that I have experience with care outside of a well-run independent practice, I'm starting to believe that more regulation IS needed even if it adds some costs to the industry as a whole.  Nobody should have to put up with being ripped off, and big corporate dental organizations shouldn't be allowed to "game" insurance companies or patients with these kinds of practices--it just raises everyone's costs in the end.

This report doesn't surprise me.  In the couple of years since my dentist moved/sold his practice to Forward Dental, my billing has been very confusing with multiple unexplained additions and subtractions by Forward Dental.  They tell me at the counter before and after my visits that they know the exact charges and even make me sign a "treatment plan," in the dental chair.  This "plan" is really just an agreement to pay a specific amount, which they usually require me to pay before I leave the building.  Often I later get a credit on my account from them or an additional charge--much like the second visit charge you incurred for closing the tooth after a root canal.  These charges are completely unexplained, and none of the several receptionists I've spoken with has any additional info other than that her computer shows the charge. 

One time I came in for an emergency visit and was forced to pay $147 from a previous visit before I could get treated.  The previous visit was supposed to have been handled by my insurance and my previous payment.  I was hopped up on Vicodin at the time, but still I talked with the receptionist for quite awhile trying to figure out where that charge had come from given as I'd paid my previous bill in full.  She had no information.  I needed the emergency service or I would have walked out and left the appointment hanging pending resolution of this amount.  The next time I came in, the receptionist told me I was overpaid and had a credit, but of a smaller amount.  I still don't know why the extra charge was imposed.

I have a strong feeling (but can't prove because of lack of detail billing) that Forward Dental is ripping me and my insurance company off on these charges.  One of my theories is that they bill what is reasonable and customary on the first visit, and then research what insurance will pay with a PA before they bill insurance for the charge.  If insurance will pay more, they bill for the max amount the insurance will pay, which then raises the percentage the patient has to pay.  (For example, if they charge $500 for the first visit and expect insurance coverage of 80%, they take payment from the patient for 20% of that, or $100, on the first visit.  If they then file a PA and discover insurance will pay $800, they send a bill for $800 to the insurance company, which pays $640 instead of the $400 they would have settled for initially.  But now the patient owes an additional $60, or 20% of the additional $300 they billed the insurance.  But that's just a theory of mine.) 

In any event, I'm sure they are playing games with the numbers after I actually leave the office--my "paid in full" payment is never the end of it.

My advice is to leave Forward Dental--even if you like your dentist.  It's just not worth getting ripped off with all this bait-and-switch confusion.  And my belief is that any dentist that will work with these con artists probably has integrity problems of her/his own, too.  There are plenty of other dental outfits a dentist can work for that are honest, even if s/he doesn't want to set up an independent practice.

What's ironic is that my dentist has always been against further regulation of the dental industry.  He and I have talked about this many times over 20 years and I've agreed with him up until now.  But now that I have experience with care outside of a well-run independent practice, I'm starting to believe that more regulation IS needed even if it adds some costs to the industry as a whole.  Nobody should have to put up with being ripped off, and big corporate dental organizations should never be allowed to "game" insurance companies or patients with these kinds of practices.