ComplaintsforPacific Crown Hill Dental

• Initial Complaint

  03/15/2023

  Complaint Type:

  Order Issues

  Status:

  Resolved

  More info

  On 05 December 2022 I had a crown done at Crown Dental. The total bill was $1,436, of which I paid $743.00 at the time with another $693.00 as the estimated contribution of my insurance. Dr ********************** had recommended the crown during an appointment in early 2022. I subsequently received a notification from my insurance (United *************** Advantage) rejecting the claim on the grounds that the procedure failed to meet their criteria for need.I subsequently contacted Crown Dental twice by telephone to ask if there had been a mistake since this had happened only once before (I've had several crowns done at this practice) and on that occasion Crown Dental had resubmitted and the claim was accepted. Also, if there had been any doubt on the need for the crown, the practice had the option of obtaining pre-clearance from my insurance as they had done when needed in the past. The attitude of the staff was essentially that those were the breaks with insurance and it really wasn't their problem - this after I had been attending this practice for a decade, ever since I retired in fact. I subsequently received a bill 60 days due for an adjusted amount of $449.00 (insurance contract adjustment). Since the bill was overdue we paid the balance. In summary, even though I have dental insurance I have paid the full cost of this crown in the amount of $1192.00. My complaint focuses on two questions. First, in view of the rejection by my insurance company, was this crown, which I agreed to only on the recommendation of Dr **********************, really necessary? Second, if Dr ********************** maintains that it was, why was Crown Hill Dental unable or unwilling to press the case with UHMA which had accepted all previous claims submitted for work at Crown Dental? I wrote to Dr ********************** on 22 February 2023 (with payment details for the outstanding balance) laying all of this out and expressing my intense disappointment at this outcome. To date I have received no response, not even a telephone call.

  Customer response

  04/18/2023

  From: ********************************** <**********************************>
  Sent: Tuesday, April 18, 2023 9:30:17 PM
  To: Info <**********************************>
  Subject: Message from BBB.org

  Re Complaint # ********-D1521 This is to notify you that *********** ********************** of Crown Hill Dental did reach out to me by telephone more than once, almost certainly as a result of my complaint to the Better Business Bureau. As I suspected he had no knowledge of the matter prior to receiving what I believe was your communication. He was extremely apologetic and gracious in assuring me he was both embarrassed and angry that the matter was handled the way it was and he promised to reimburse me the insurance portion of the cost of the crown, irrespective of whether my insurance would approve a resubmission of the claim. I waited to contact BBB until I received the reimbursement which I now very recently have. I am satisfied that the problem was inexperienced and, perhaps, insufficiently trained administrative staff - again what I suspected from the outset. Dr ********************** stated he was rectifying these deficiencies. Sadly, and despite Dr ************************ kindness in this matter and the fact that he is a truly excellent dentist, I cannot bring myself to return to Crown Hill Dental after the way I was treated. However, I want to thank BBB for your efforts, without which I am certain, this matter would never have been brought to Dr ************************ attention and I would be out almost $450.00. Thank you so very much. ************************* *************************** Seattle ** ***** Tel: ************ (mobile)

  Sent from ************************* (*********************)

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩