Expert: Mark Bornfeld DDS - 1/18/2007

Question
I need your perspective as to how best handle a billing practice which occurred in my dentist's office.

Several months ago I was advised that I needed a "cleaning,"  a complied a shortly afterwards received a bill for a "full mouth debridement."  The need for this procedure was never discussed with me nor did I concur at the time the procedure as completed. I assumed I was receiving a "cleaning," as it did not seem to differ significantly from other cleanings I had received in the past. I was a little perturbed as I feel I my patient rights had been violated in that the procedure should have discussed before treatment. I now understand the differences between the two procedures and the needs of one versus the other and would have complied with my dentist's recommendation but I was not given given the opportunity to decide. I discussed my feelings with my dentist who  voluntarily offered to waived the charge. This surprised me as I had not requested that he do so.  

I have subsequently received bills and one nasty note from his accounting dept. requesting  payment for the treatment. I advised them to speak my dentist about the bill/costs it seems to no avail. I'm uncertain at this what to do. The debridement/cleaning was completed in part, with cleaning and polishing remaining to be completed. I'm inclined at this point to just pay for the portion of treatment/services that was received even though at least my dentist waived  all charges.  Even though my dentist did not request it, am I liable for  payment for the full amount of a treatment even though I have only received treatment in part if I decide to pay any amount? Is it possible to prorate a bill for only the  services rendered?  Am I better off cutting my losses paying the pay in full and just working away or shall I mention to my dentist the charges which I continue to be billed for charges i thought had been waived. It's not a significant amount of money ($169) and easily payable so it's more a matter of trust then cost involved. Although, I don't consider my dentist to be at fault, I will no longer be using his services and I not be returning to complete my cleaning/debridement treatment. Thus if I pay in full I will be paying for services not rendered. It a mess and one I want to put behind me. From a dentist's perspective how would you prefer a patient to approach this situation? I realize that a dentist must be willing to support his/her staff. How can I let him know that the rude and nasty actions of his staff have cost him a client without putting him on the defensive-- or should I let it go and cut my losses which whould be a shame as I really do respect his skill as a dentist. dentist?  

Answer
Dear Mary,

Is your dentist a principle proprietor/owner of the practice, and empowered to set office policy? Then why on earth would you pay a fee that he explicitly waived?

Personnel that are placed in positions that deal with billing are often bulldog types that are not interested in civility-- they are judged by collecting on accounts. You need to bypass the billing workers and speak directly to the dentist and inform him that you have been billed in error. You might also wish to alert him to the fact that his billing department may be costing him more in business than it is saving in collecting overdue accounts-- that should get his attention. If you don't tell him, he will have no way of knowing.

Good luck!

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY