My wife and myself received dental services through PMI Dental Health Plan (Delta Dental) here in San Diego.
We selected University Towne Dental (University City, San Diego) as our local dental office. We picked it because it was close to our house and on PMI's list of participating offices.
In July we followed the advice of a UTD dentist and had some anti-bacterial drug injected in my wife's gums. She bled at night for two days. We called them and they suggested aspirin. Shortly thereafer, I told UTD we would no longer be using their services.
We paid out of pocket to go to a dentist that was not part of the PMI network.
Eight months later I'm contacted by some very aggressive collection agency (West Coast Operations) here in San Diego. They said RAMO Management/UTD had filed for Chapter 7 bankruptcy. West Coast Operations, as representative of the bankruptcy trustee, wanted to collect monies I owed to UTD.
I told West Coast Operations I owed no money. They said I did. They sent me via mail, a leger from UTD which showed I owed money. I went through my credit union to get a check image to prove I was paid up.
Thank god I paid with a check. What if I had paid with cash. Who keeps a receipt for 8 months?
I contacted PMI Dental Health Plan's Quality Management Department to complain about the way this was handled. I supposedly owed UTD money, but they never contacted me in 8 months. They had my phone number, my address and I live less than a mile from their offices. I called them to let them know I was no longer going to be using their services (due to the way my wife was treated) at the beginning of that 8 months and no one said there was any amount due. This is one of those offices where they would tackle you if you tried to get out without paying for services.
I complained to PMI Dental Health Plan because I got called by a collection agency because they did not keep accurate records and because they sent our confidental dental records to that agency.
So far, PMI Dental Health Plan is acting like this is no big thing and I should not be bothering them. It's a big thing to me and I'm wondering if there are other folks out there in California who belong to PMI, go to dentists that are on PMI's provider list, get ripped off, and are brushed off by PMI when they complain.
Is PMI responsible for ensuring that dentists on their provider list are ethical in their dealings with PMI members? Who do we go to in California to complain to if PMI does nothing?
Am I the only one experiencing this?
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