Consumer complaint received 2019-03-27
Company: Capital Accounts, LLC
State: SC
Product: Credit reporting, credit repair services, or other personal consumer reports
Sub-product: Credit reporting
Issue: Incorrect information on your report
Sub-issue: Account information incorrect

Complaint:
On XX/XX/XXXX, Capital Accounts stated in part we have no way of knowing the details the creditor 's contract with the insurance company for the services he received in XX/XX/XXXX and XX/XX/XXXX. We also are not in possession of the EOBs ; the consumer is free to contact his insurance company and, if he believes there is a discrepancy, provide us with those EOBs so that we can evaluate his dispute. 

I have now obtained the EOBs from XXXX XXXX XXXX. Before discussing the discrepancies. I think it would be beneficial to recap the events, starting with my initial visit to XXXX XXXX. 

In the Spring of XX/XX/XXXX, I was looking for a new XXXX XXXX ( my insurer ) Provider in the XXXX, SC area. I selected the XXXX XXXX XXXX in XXXX, SC and had my initial consultation with XXXX XXXX on XX/XX/XXXX. At that visit, I was advised by XXXX XXXX that I needed to replace the crowns on two of my teeth. Even though I was experiencing no discomfort, I took XXXX XXXX recommendations at face value and agreed to proceed since I was told that the work would be billed to my insurance. I also knew that I would have co-pays from XXXX XXXX once the work was completed. The crowns were installed and the work completed in early XX/XX/XXXX. Subsequently, I dont remember ever getting a statement from XXXX XXXX, but, since my wife and I, at that time, were both going through some very serious medical issues, and checking for statements in the mail was not very high on my priority list. In XX/XX/XXXX, I had a routine visit with XXXX XXXX for cleanings. There was never any mention of any past due balance, nor did XXXX XXXX request any payments for the services provided at that visit. 

I then started to receive phone calls from Capital Accounts LLC. While I then remembered that I owed some copays from the work that was done, the amount that Capital Accounts was requesting seemed excessive. I seem to recall asking Capital for a detailed statement of the services that XXXX XXXX provided but do not remembering ever receiving same. At some point, I was tired of Capital Accounts continually phoning me and I finally agreed to a periodic {$20.00} monthly payment. 

A few months ago, I asked a friend to help me clean up my credit reports. During this process, he asked me some questions about the Capital Accounts claim which I could not answer. As a result, I filed my initial complaint with CFPB on XX/XX/XXXX in order to get additional information. 

As a result of my complaint, Capital Accounts sent me a copy of the SINGLE PATIENT LEDGER sheet from the XXXX XXXX XXXX which I had never seen before. One look at it and I knew there was a problem. It did not show any insurance payment for the work done on the crowns. I assumed that XXXX had failed to file the claims with XXXX XXXX. In their response, Capital Accounts said it was my responsibility to obtain the EOBs, send them to Capital, who would then evaluate any disputes. 

I then contacted XXXX XXXX and received the EOBs for the crown work which Ive attached. On page two it states that XXXX would not pay for this work since five years had to pass before a replacement crown would be covered by my insurance. I immediately called XXXX for a further explanation. I was informed that the same crowns that XXXX XXXX had replaced on XX/XX/XXXX were also installed on XX/XX/XXXX by my prior dental provider. XXXX also told me that XXXX XXXX ( as a XXXX Registered dentist ) should have called for a Pre-determination $ estimate on the major work to be performed XXXX XXXX XXXX did not do. XXXX further said that, had XXXX XXXX asked for the Pre-determine estimate, XXXX would have informed him that my insurance would not have covered this work. Had XXXX XXXX, in turn, informed me that the work was not covered by my insurance, there was absolutely no way that I would have told him to proceed, especially since I was experiencing no discomfort. It also now raises the question in my mind Was the replacement crown work even necessary? 

As far as I am concerned, the {$1700.00} for the crown work included on the Single Patient Ledger is not a collection issue, but a legal one. I now believe XXXX XXXX performed the work under misleading circumstances ( perhaps even fraudulently ). There is no way I am going to pay him for this unnecessary work. If you disagree with my assessment in any way, please explain your rationale for doing so I may fully understand your position. XXXX XXXX is free to bring a lawsuit against me for this amount, as it is his prerogative. I strongly believe, as does my attorney, that he will not prevail and I also believe I will be awarded any legal expenses that I incur in my defense. 

In summary, after deducting the {$1700.00}, there is a balance due of {$170.00} for copays on the other work which I agree is due to Capital, as XXXX XXXX agent. If you wish to recalculate the interest charges on this balance, that will be fine, but only if you provide me with the copy of the agreement that I signed allowing interest to be charged to me. If you recall, in my XX/XX/XXXX complaint to you, I requested a copy of said agreement, but you have not, so far, sent it to me. 

Otherwise, you have acknowledged that I have paid you {$500.00} to date, which means I have overpaid you {$320.00}. After you have had a chance to review the materials, I will expect you to send me a check for this amount. I am not sure you have my current mailing address. Please send to : XXXX XXXX XXXX XXXX XXXX  XXXX, SC XXXX Thank you for your prompt attention in this matter.

Company public response: Company believes it acted appropriately as authorized by contract or law
Company response to consumer: Closed with explanation