SmileCare is one of many contracted Dental offices in the DeltaCare USA Network of prefered providers.
I made an appointment as I had a Tooth partially broken and in pain. They informed me I needed a Root canal and was missing a cap on a previous root canal told me my share of the procedure would be 525.00 due day of appointment.
Day of appointment they asked for 1,050.00 said both teeth needed a root canal. 325.00 for non surgical access on both and 200.00 for each tooth for a needed irrigant. So I paid them they drilled and filled both with a temp filling and scheduled me another appointment to crown the teeth which my benefit book clearly states no cost to me. They wanted another 1.050.00 to complete the work, despite my telling them my plan says no charge to me.
Before I could make the next appointment I received a Denial from Deltacare for the D3331 procedure code that smilecare billed them for with a code of M47 which states it is not a separate and billable service and neither the plan or the enrollee is responsible for any such unbundled component.
So I get a hold of Delta and tell them what I have paid. They instructed me to file a complaint online and I would get a resolution within 30 days. I did it said smilecare owed me 725.00 and I would receive a check no later than 30 business days. And that I was to pay nothing for the crowns as they are covered in my plan.
I did not receive the refund within the time allowed so I called Delta's quality management dept, They told me they were going to call the corp office and I would have the refund within 20 days. During this time one of the temp fllings fell out so I made another appointment to have them complete the work. Again they asked me for 1.050.00 I explained showed them the letters and booklet they still insisted on charging me. So I left.
They are now billing me 33.00 for that appointment and I still haven't received my refund. The teeth still have no crowns and I just don't know what to do, it has been like this since Feb 28 and still no refund. I question who is the crook? Smilecare or delta or both?
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