Dr. Mojgan Ghiai, DDS

I had a root canal procedure on Sep 3. I paid what was quoted to me by the office before the service.

After the claim was processed by my insurance (Aetna), I had a disagreement with the office regarding what I paid for. According to my EOB, I should have paid $150 less. 

I asked Aetna to look into this for me to see if I'm responsible for the $150.

On Oct 8,

Aetna closed the investigation and responded with the following in writing to me.

"After a complete review of the information submitted, the Committee, which includes at least one licensed dentist, has determined MTAD if used, is considered inclusive in the root canal and is not a permitted charge. Furthermore, the office may not bill you for the use of MTAD. Aetna would like to apologize for any unpleasant experience you feel you may have encountered with Dr. Mojgan Ghiai"

"......,a refund in the amount of $150.00 is due."

Shortly after this, I asked Aetna to reach out to the office and asked for the refund that Aetna said that I should be getting. This is what Aetna told me in writing.

On Oct 9,

"I called the office and spoke with <the office manager's name> to inquire if your refund had been issued, and she said they absolutely will not refund you, they have your signed consent for the treatment and that they will only pay this if you take them to court and they are ordered to pay it there.

Therefore we have escalated this by filing a follow up complaint."

On Oct 11,

Aetna closed the follow up complaint and again, they ruled in my favor. Aetna issued me a check of $150.