ComplaintsforOral Surgical Institute

• Initial Complaint

  10/09/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  10/16/2023 I was seen at Oral Surgical Institute (OSI). A girl called me back and said we needed a x-ray. I was unaware a ** was done.~10/29/23 I received a denial from my health insurance stating the ** scan was not medically necessary. I called and was told Dr. ***** sent a letter to insurance to appeal.11/16/23 On my next visit, I asked the front desk for an update. The girl said they were still waiting but if it was denied again, they would probably just write it off. 5/8/24 I received a bill from OSI dated 5/3/24 for $126.60. I called OSI on 5/8 and spoke to ******. Insurance denied claim again. I explained to her that I was told they would probably write it off. They denied I was told this. She suggested I follow up with insurance. I requested copy of the letter Dr. ***** wrote and sent. I received consultation notes which does not address the ** scan. I replied to ****** requesting the actual letter. She stated the consultation note was what was sent to insurance. 7/29/24 I finally spoke with my insurance. They said to have *** contact the provider line to discuss what was needed to support the treatment was needed.I emailed ****** 7/29 and requested she contact the provider services per my insurance and provided the phone #. 8/8/24 No response from ******. I emailed again requesting update. I received no further communication from *** and believed the issue resolved. 10/9/24 I received a text message from a collections. I contacted *** and spoke with ******. She said ****** was out on maternity leave when I was emailing. I pointed out email should have been forwarded/monitored, an away message applied, or emails responded to upon ******** return.****** said since there was nothing else they could do, they sent it to collections on 7/30. I have been lied to multiple times and my request for assistance has been ignored. I want the collections to be withdrawn, balance reduced to $0, and I want corrections to my credit report.

  Business response

  10/10/2024

  At this time the patient has been pulled from collections and we are taking further action with an appeal from the insurance to try and get this approved.  This could take anywhere from 3-10 weeks to get an answer back, we will update the patient and make this top priority. 

  Customer response

  10/17/2024

   
  Complaint: 22404044
  
  I am rejecting this response because: while the company has stated they are again working the case and making efforts towards resolution, the issue has not yet been resolved. I wish for the complaint to remain open until resolution has been reached. 
  
  Sincerely,
  
  ***** ****

  Business response

  10/23/2024

  At this time we have decided to write-off the balance so the patient does not owe anything to our office due to the inconvenience.   No additional action is needed from the patient at this time. If the patient wishes to obtain a copy showing the write off and zero dollar balance, please reach out to via the email below.

  ****** ****** - **************************.  

  Thank you,

  Oral Surgical Institute

  Customer response

  11/02/2024

  I responded previously that this case has not been resolved and that I did not want to close the case. Please reopen the case. 

• Initial Complaint

  03/06/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Upfront overpaid $875 based on estimate for wisdom tooth extraction for my son. The procedure was done on Jan 6, 2024. As of March 6, 2024, still awaiting refund. Have called the office multiple times. They have said office is "behind" and check will come from corporate. I have received this response on 2 different occasions a month apart.The procedure itself was great. The billing process not so much. The out of pocket up front requirement seemed very high compared to other estimates to begin with. Now slow pay of refund.

  Business response

  03/06/2024

  The reason for the credit is due to insurance contracted rates changing.  Our apology, we are not notified when insurance increases or decreases their fees.  That is the reason for the overpayment after insurance paid.   We did receive payment and refunds are processed every 2 weeks and then sent to our accountant and they draft the check and mail it.  This often can take 3-5 weeks.  At this time the check should have already been submitted and sent.  Due to the inquiry we have called the patient's father and submitted a refund directly back to the credit card.  The father should receive the funds within 2-5 days as of today.  Again, we apology for the delay.  

   

  Customer response

  03/07/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  *********************

• Initial Complaint

  09/03/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  August 31, 2022 TOOTH EXTRACTION Paid $497 before the procedure. Then.... billed my insurance over $1,200! The doctors were unable to insert the needles properly and took an extended period of time due to the lack of experience drawing blood or starting an IV for sedation. I was only sedated for 15 minutes and charged triple for sedation! This is outrageous. I'll be speaking with****** asap for assistance disputing the total charges. This place should be put out of business. There are several hundred dollars filed thru insurance erroneously, for services not rendered. There is a maximum or cap on medical or dental procedures and this place has far exceeded that! Also, I have bad bruises on both of my hands due to failed attempts at inserting an I.V.

  Business response

  09/08/2022

  Business Response /* (1000, 5, 2022/09/06) */ All out of pocket for our procedures are collected prior to the procedure. We did verify the insurance to get the most accurate out of pocket, but we do tell every patient that it is an estimate and once insurance processes the claim you could owe more or receive a credit if there was any change to either procedure time or the contracted rate with the insurance. Dental insurance claims do not have a response to add the patient's out of pocket, once the claim is processed the insurance will tell us what we can and cannot collect from the patient. All this information is sent via an explanation of benefits once the claim has been processed. We have not received the EOB to determine an outcome to this out of pocket. Insurances process claims within 2-8 weeks. The amount that goes on all claims is our "UCR" usual, reasonable customary charge, once the insurance receives the claim they adjudicate the claim to the agreed amount between the insurance and the office. This is common medical practice. At this time, we do not have the adjudicated amount since we have no received the EOB. Currently there is no balance owed. As far as the amount of sedation charged - this starts when the procedure starts and while the patient is recovering from anesthesia. During this time we are constantly monitoring the patient's vitals and the patient is still receiving fluids. I reviewed the chart and the sedation amount was accurate. As far as attempts or bruising after an IV. Most of our patients have fasted which sometimes causes dehydration which can make it difficult to find a good access point for the IV. Bruising is also common after insertion of an IV. We do suggest to return to the office for any post-ops if there is concern or pain after a procedure. Post-ops are offered to all of our patients at no charge. Consumer Response /* (450, 6, 2022/09/06) */ I have spoken with the business and would like to cancel the complaint. After further consideration, I do not find it necessary nor have any other grievance or issue with OSI. Please cancel my complaint with the BBB. As always thank you for your time and attention to this matter. Sincerely, *********** *****

• Initial Complaint

  04/05/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  In December my son was scheduled to have his wisdom teeth removed. I called a few times to get an estimate of what the cost would be and the office stated they couldnt give a quote or a general idea in which I thought was odd given I was providing insurance info and only seeking my amount due. We get to procedure done and I was advised I had to pay over 1400 out of pocket for my sons wisdom teeth removal. I advised this can't be correct. I explained I personally and my daughter had the same procedures done and the cost was less than $100 after insurance. The office made no calls to verify my insurance they simply kept say this is what you owe and we will reimburse you if needed. My son was in pain and due to return too college so I had the procedure done and stated I would address it with my insurance the next business day. I called my insurance and they advised the procedure was covered at 100% and they would be sending a check to the dental office. I waited a few weeks after I received my explanation of benefits to verify the insurance company had indeed paid the claim. I have phoned the dental office over 7 times and every time there's a different story in regards to them mailing me my 1400 reimbursement. The story has changed from they only received partial from the insurance, then too well we have to see if there any extra services or medicine that wasnt added which sounded suspicious. The next story I received is they never received a check. Then I received a story that the check was delivered but to a different office but no one has verified the amount and we are 3 months in and I haven't received refund of my $1400. I have called and the office will not give me the name of the operations manager or have them call me back to resolve. They only state they will email he or she. Please I would like to get this resolved and my $1400 returned so I can pay for things my family needs.

  Business response

  06/30/2022

  Business Response /* (1000, 11, 2022/06/24) */ On 1/6/22 we called insurance (see attached verification forms along with rep and confirmation number for the call) the insurance told us that medical needs to be billed prior to dental for any teeth that are not erupted, given that we have to work up the patients out of pocket based on the primary insurance which was medical at the time. Our policy is to collect the out of pocket of the primary and if secondary pays on top of the primary we will reimburse the patient. Often secondary doesn't pay on top of primary or coordinates the payment. In this situation the dental did pay but dental insurance paid the wrong provider. Once insurance finally corrected their mistake we issued the refund immediately, as you can see on the dates, and the patient has cashed the check. The check is attached and proof of it being cashed by the patient's mom is shown on the signature. Unfortunately, in this situation we were unable to refund the money immediately because insurance did not issue the check correctly. As of today 6/24/22, the account balance is zero and patient has received the funds for the refund in their account.

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