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: Their careless mistake cost me $460
2009-02-24 register | login
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Relates to: Leong F Timothy DDS

Their careless mistake cost me $460

    I am a European and I moved to the U.S. (specifically to Tucson, AZ) just over a year ago. My dental insurance company is United Concordia, and my current 12-month benefit period started on February 1st, 2009. My insurance reimburses a $1200 maximum per benefit period. During my previous insurance benefit period (from 02/01/08 to 01/31/09) I underwent extensive dental work (including several crowns) at Dr. Leong's office. My insurance payments reached the $1200 maximum towards the end of 2008. At that point, I explicitly agreed with my Dr. Leong and his secretaries (who are also responsible for scheduling the patients' appointments) to halt all scheduled procedures, take a break, and complete the remaining dental work at the beginning of the following benefit period. I explained my intentions and illustrated their meaning and their nature repeatedly and very clearly. Then I told the secretary who was helping me that I did not know the exact starting date of my next benefit period, and I asked her whether she could possibly look it up for me and schedule my next appointment after that date. At this point, she answered "Certainly!", looked at something on her computer, and scheduled me for a crown on January 15th, 2009. However, unbeknownst to me, that date was still within my PREVIOUS, already-maxed-out benefit period. Assuming in good faith that she had been accurate and that I could trust her, I showed up for the appointment and, after the procedure, I paid my estimated copay (i.e., 50% of the full charge). Now, however, I have received a letter from my insurance company stating that they will not pay for that crown because it was placed during my old (and already maxed-out) benefit period. Therefore, I will have to pay the remaining 50% of my crown out of pocket. Dr. Leong has just billed me as well. I will foot the bill, but, if the secretary had been more careful, and had she paid closer attention, she would not have made such a careless mistake. If my appointment had taken place just two weeks later, I would have saved $460! "
 
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2009-03-05 Honest and serious after all
I am the European patient who submitted the previous review. After discussing the matter with my dentist, he admitted that what happened was his (and his staff's) fault. They will resubmit the paperwork to the insurance company and, if it still won't pay, Dr Leong will not make me pay for the procedure. His decision shows a serious, honest and professional attitude. " --guest

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