A visit to the dentist might be expected to cause a day or two of mouth and gum discomfort, but not a four-year pain in the neck. Unfortunately, that's what it gave Earlysville resident Dan Brown, a former Marine helicopter pilot and currently a teacher at Monticello High School.

Brown and his family visited the office of dentist Scott Knierim in February and March of 2003 for routine maintenance. All were insured at the time. As they had done previously, the Browns made their co-pays and figured they were done for the year.

Several months later, however, Brown received a $942 bill from Dr. Knierim's office for the visits. Brown called the office and says he was told the insurance claims for the visits had not been filed, but that it would be taken care of, and he could ignore the bill.

Another bill arrived in the fall, however, generating a similar call and a similar promise that the claim would be filed. And he adds that a third contact occurred sometime in early 2005, when, Brown says, he was told the earlier problems were due to office staff who were no longer with the practice and, yet again, that the claim would be filed.

Admittedly (and understandably), Brown's memory of dates and specific occurrences is a bit fuzzy, and since at the time he did not expect a protracted problem, he was not documenting his activities. He does recall, however, that the contact was sporadic. "We wouldn't hear anything and think it was fine," he told me, "then we'd get something."

The matter was still hanging over Brown's head through the summer of 2005. Brown apparently wrote the practice on August 25-- he can't specifically recall what caused him to do so-- to provide his family's insurance information.

Still, according to Brown, no insurance claim was ever filed.

There the matter sat until Brown received a collections letter from Charlottesville Bureau of Credit (CBC) in late 2005 or early 2006. Brown contacted CBC to explain he didn't owe the money, but was told to take it up with Dr. Knierim. So again he called Dr. Knierim's office, but was told to speak to CBC.

Paging Joseph Heller!

The matter took an even more serious turn later in 2006, when Brown was rejected for a student loan for his daughter-- a matter since resolved-- because CBC had dinged his credit report.

Then in February of this year, CBC threatened Brown with litigation, which is when he finally got in touch with the Hook.

Dr. Knierim, citing patient confidentiality, said he could not discuss Brown's specific situation with me. He said, however, that patients typically receive "multiple opportunities" to clear up billing problems, including monthly statements, at least one phone call, and a "We're-sending-this-to-collections" warning letter.

He added that when problems like this typically arise, it is due to patients providing incorrect insurance information and subsequently ignoring the plethora of bills and warning letters that land in their mailboxes, until something dire-- say a collections letter or a dinged credit report-- spurs them to action. By then, the insurance provider doesn't want to deal with the claim any longer.

That said, Dr. Knierim agreed to resolve this matter and said he will first seek to halt CBC's collection efforts. Brown, in the meantime, is to meet with the practice's office manager to go over his account. The next step will depend on what that review shows.

Dr. Kneirim said that in his 35 years of experience, most problems like this could be fixed by "better communication." I couldn't agree more, and Brown and Dr. Knierim finally are heading in that direction. We'll be checking back with them to see how it went. #