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Q: I had dental work performed at Coast Dental in Port Richey between January and August 2002. According to policy, I paid in full at the time of service.

Three years after the last visit, I received a bill for $34.50. I have written several letters with no response from Coast except another bill. I requested a detailed payment history and when it arrived, I was surprised to see that I had actually overpaid by $107.50 on June 27, 2002. On Feb. 10, 2003, my account shows a "fee schedule debit" of $142. This was six months after my last appointment. I've written again, explaining that it is Coast that owes me, but I only get more demands for payment. How can my account be overdue if I overpaid?

Could you please see if they will listen to you, stop billing me and send my refund?

Michael Johnson

A: In early April, you e-mailed to let me know a representative from Coast Dental had contacted you by phone. "They told me we had been in the day before the $107.50 credit was posted," you said, "and that it was another Michael Johnson who had that visit posted to his account."

Patient relations coordinator Jean Wilkerson responded from Coast Dental Legal Department in Tampa with her investigation of the billing confusion.

According to your dental charts, you had service on June 25, 2002. Your accounting records don't show the service because it was posted to the account of another Michael Johnson. The fee was $142. Wilkerson says your account wasn't charged and you made no payment.

Two days later you had another procedure, unrelated to the first. You were charged $227.50 for the procedures that day. You were also apparently charged for the procedure from June 25, which had never posted on your account. Wilkerson explained that the employee handling your account that day charged the wrong amount and that's what created the credit balance of $107.50. If you had been charged correctly, your balance would have been $142.

On Feb. 3, 2003, the mistaken charge to the other Michael Johnson was corrected. It was posted to your account as the ambiguous "fee schedule debit." Subtracting your outstanding credit balance, the charge resulted in a $34.50 shortage.

I don't understand why you weren't contacted once they found the mistake. Wilkerson said corrections and adjustments are made to patients accounts all the time through the corporate office. "Patients aren't going to be notified of every correction," she said.

The adjustment should have put your account into the billing cycle, Wilkerson said. But you didn't receive a bill until more than two years later.

Finally Wilkerson said that her review showed you had never been charged for a $599 crown you received on Aug. 9. She explained that you had two crowns put in that day. One was a remake from an earlier application for which you had already paid. Somehow, the new crown was overlooked when you paid for services that day. "As a gesture of good faith," Wilkerson said, "Coast Dental will waive the $599 charge." It won't, however, waive the $34.50.

Wilkerson had detailed answers and the figures worked out, so I believe the charge is valid.

The real problem is in the front office. They charged wrong accounts, charged inaccurately and omitted charges altogether. Then the company ignored your requests for explanation. I have to wonder if other patients have received this kind of "service."

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