My husband and I both started going to Champlain Dental in May of this year. We chose this practice since it accepted our insurance and had good reviews overall. Unfortunately, this was not our experience. It may be an isolated case but I am taking the time to write this review and provide a detailed account of our issues so that hopefully something can be done to rectify the problem and allow others to make an informed decision.
My initial visit with Dr. Boyd was on May 9th, for a routine cleaning and x-rays. I had several follow up visits for a cavity and a tooth extraction and mouth guard. Over the following weeks, we started receiving multiple "Explanation of Benefit" forms from the insurance company for the same visits showing zero eligibility each time. I received 6 claim forms in total just for my initial visit. I was told by the front desk staff that they were having issues with our insurance company and they were working on it. However, this continued to happen over the next few months for both my husband and myself. We had never had issues with our insurance before and I had a claim with the specialist during this time frame that went through without any issues or delays as had claims with our previous dentist. I also realized that during several of my visits the office kept having issues with their system and it was even down during one visit. We finally started to get correct claims in August and I noticed then that the previous forms had shown "Out of Network", with an ineligible member ID vs. "In Network" on the correct forms. I mentioned this to the front desk during one visit but never received any explanation as to what happened.
The day that I had my tooth extraction they had ran completely out of nitrous oxide, so I had nothing for the procedure other than freezing. Normally I would not require it but it was a tooth with a previous root canal and cap and I have difficulty freezing. It took an extremely long time...I'm guessing over 1.5 hours. Apparently it was a very difficult extraction and the tooth was breaking apart one piece at a time. After a painful amount of time, Dr. Boyd suggested that I go to a specialist to complete the procedure, since there were portions of the root canal he could not get to. I was told that my records would be sent over in the hour between leaving there and the appointment. I was sent to the office of Dr. Paul Boerman. While the staff was very efficient and I was brought in right away, I had to sit in the chair for another 15-20 minutes waiting for someone at Champlain Dental to go over to the fax store in their complex to fax my records since their system was down, yet again.
Even though all insurance payments have long been made, one particular claim has a difference between what the insurance company allowed and what Champlain Dental was charging. As an "In Network" provider, they are required to absorb and make an adjustment on our account for this difference, yet when I discussed this with an individual at the front desk, he basically told me that I was wrong and we owed the amount on the claim form, claiming it was complicated. As I had to return to work I told them that as a certified accountant, numbers and insurance claims did not "confuse me" and that they needed to look at it again. I have since confirmed my numbers directly with the insurance company, sent copies both by e-mail and in person showing exactly what should be written off by Champlain Dental, discussed with an individual at the front desk but as of the date of this review we have yet to receive a response! Not one person from the office has called us back and we are still receiving incorrect statements. I fail to understand why this is not common knowledge for anyone in the industry who deals with insurance claims! We have always had adjustments done automatically for any differences between what the insurance company allows and for what is charged. We have spent so much time at each visit discussing the billing issues that the front desk forgot to book a follow up visit for Dr. Boyd for my mouth guard. I haven't received a call about that either.
We were not going to pay our final balance without a proper statement so several weeks ago my husband called the office and asked a certain individual he had been dealing with to call him back so we could get everything straightened out. After another week of hearing nothing, he went to the office to drop of a check for $157 to pay off our corrected balance. They acknowledged receiving our voice message and said they were waiting to see if they were getting any more insurance money! There was no more money coming! Even though he made our dissatisfaction very clear to them, they have not corrected anything, called us, and have not even cashed our check, a personal pet peeve of mine! While Dr. Boyd is great, it's not worth the frustration! read more