Western Dental / horrible dental business!
I had a dental appointment for June 10th. When I made the appointment, I had specifically told them that I needed to come in before the July 1st cut off date for Medi-Cal/Denti-Cal patients because I have a plastic stayplate that needs to be repaired. (A stayplate is a little plastic partial, also referred to as a ''flipper', and is made to look like my bottom two missing front teeth.) Medi-Cal only pays for one every 5 years, which is stupid to begin with, because they are TEMPORARY and not meant for long term usage. I was assured on the phone before I made the appointment that Western Dental can fix it.
I went to the office for my appointment at 9:00 am. I ended up coming in the door 5 - 10 minutes late because I was given an incorrect address for the office. I was assured that they could see me, and that I only had 2 - 4 people in front of me. While I sat there in the waiting room, I started seeing people getting called to the back that had gotten there AFTER me. I asked twice how long I would have to wait, without a valid response. I was in the waiting room for over 3 hours.
I was then taken into a small room for x-rays. I overheard the two dental assistants debating on who should take the x-rays because the one girl had never done them before. I waited in that small closet of a room for 15 mins. I told both assistants that my other teeth were fine, and that I just came in because I need to get my stayplate fixed.
I was then taken to a large room with little partial compartments and directed to a chair in a laying down position. The area was dirty, with used cotton rolls and other material on the floor. I heard one child screaming in pain. I tried not to look in their direction. There was NO privacy whatsoever as seats were made to extrude from the partial compartments. My x-rays were in plain visible eyesight for everyone to see. The monitor in front of me had a list of different patients names, which I believe violates a patient's confidentiality rights.
The dentist finally came to me and tried to look in my mouth. I told him that I was just here because I needed to get my stayplate repaired. He told me (without even LOOKING at it!) that I have to take it back to my original dentist to get it repaired. My original dentist is 2 hours away (I had moved) and had no way of getting there. He then said that they have an employee that makes them, but they cannot repair my stayplate because it is plastic. So then why refer me to the original dentist if it is non-repairable? I asked the dentist to put in a request for a new one, to which he said that I had to call Denti-Cal myself to request a new one. I left crying.
While I was in the parking lot, I called Denti-Cal [protected]). They told me that they do not have record of my original stayplate, so I can have the DENTIST put in a referral for a new one. I went back in to the office, explained the situation, and WATCHED the dentist fill out a referral form, which I was told would be faxed that same day to the billing department.
I called Denti-Cal to check on my referral. They said they never received it. I called the corporate billing office for WD at [protected]. I talked to a woman named Patti at ext. 4607. They claimed they never received the request for referral. I was told to call the branch. The receptionist told me that Denti-Cal probably just didn't process my claim yet. I told her it is because they haven't RECEIVED it! I was then put on the phone with Sophia, the medical billing Supervisor. She said that they had lots of patients whose claims were never sent because they were so busy and that Denti-Cal would probably deny my claim and tons of others because they were being filed so late. I then replied that if I don't at least get a CHANCE to get an approval or denial from Denti-Cal because WD neglected to send my claim to Denti-Cal, that I would sue the hell out of them to cover the needed services. I was then told that my claim was being faxed as I was on the phone, and Denti-Cal would receive it same or next day. I ended the phone call at 4:28 pm.
I get a call from Western Dental saying that my ROOT CANAL was approved. What the hell?! Root canal? I don't have any tooth pain. I was told to continue waiting for approval from Denti-Cal for my stayplate.
I called Denti-Cal to check on the status of my claim for a stayplate. I was told that they never received a request for a stayplate, only a root canal. And now it's too late to send them a new claim for a stayplate. I called the corporate office again, who stated that they have no record of my claim for a stayplate. I then explained my situation for Jessica, ext. 4604 with customer relations. She directed me to call the branch manager. I called them again, and was patched through to the medical biller Supervisor, Sophia. Again...
She claimed to have had no recollection of me. I had to explain the situation all over again. She said they only faxed over a claim for a root canal, not a stayplate. I did NOT ask for or was advised that I needed a root canal. I don't even know what tooth they are talking about! In addition, she said I needed 3 fillings as well. WHAT? The dentist didn't even look at my teeth. How would he even know? She said my claim for the stayplate was never even processed or faxed out. I said that I cannot pay for these dental services because I have Medi-Cal, I can't find a job, and no one is going to hire me with my front two teeth missing. It's not esthetically pleasing to prospective employers or customers. She then asked me if I wanted to come in and pay to have my stayplate fixed. I just about lost my cool on that one. She apparently hadn't been listening to me at all, and I had stated that to her as well. I don't have a JOB! How can I pay for these services?
I said that I would be in the office in one or two days and I wanted a copy of every single piece of paper they had about me, and that I would be suing them. I was told that my file would be left up front to be picked up in 2 days.
ABOUT 15 MINS LATER...
Sophia called me back, asking what was wrong with my stayplate. Again... And then she said she felt bad for me and wanted me to bring it in (like I'm going to go in public without it and a huge gap where my two bottom front teeth should be!) so they can see what they can do to repair it. Translation? They don't want to be SUED, because they know that they are wrong.
Apparently, there are TONS of people that went to Western Dental before services were cut on July 1st that have claims that were NEVER SENT to Denti-Cal BY THEIR OWN ADMISSION! That was a ridiculous move on their part. I have already requested an information packet to file a complaint with the Dental Board of California. The number is [protected]. I urge everyone that has been totally disregarded in the same fashion as myself to stand up for your rights! File a complaint! Call and stand up for yourself! Just because we're poor doesn't mean we have to be taken advantage of.
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