Billing confusion at SWFL dental offices leaves seniors wanting answers

FORT MYERS, Fla. (WINK) — When you go to the dentist, you hope to know how much it will cost you. Tonight, two Southwest Florida seniors are speaking out, telling WINK Investigates that billing confusion at local dental offices left them with unexpected costs. But the offices involved—which operate under a national support network—are pushing back, saying these cases are the result of complex insurance systems, not bad practice.

Both patients felt billing was overly complex and confusing. The dental offices in question are both managed by the same dental support organization. A national parent company called PDS Health provides the administrative, financing, and billing backend. 

While the corporate network argues this allows local dentists to focus entirely on patient care, some patients tell WINK Investigates they fear centralized billing may have led to their confusion when their final invoices arrived.

For Justin Turton, a trip to Daniels Modern Dentistry in August of last year was supposed to be straightforward. Diagnosed with periodontal disease, he expected his insurance to cover the bulk of the deep cleaning, leaving him with a one-time copay.

"I said to them before you do anything, I’d like to know what this is going to cost, 'Oh, don’t worry about it,' they said. 'The only thing you have to pay is a co-pay of $1038,' I said to them, 'This is going to cover all my treatments,' and I was told yes." — Justin Turton, Patient

But when Justin returned in December, he says the office demanded hundreds more for his next visit. Frustrated, he walked out and spent months writing letters demanding answers with no response and hoping for a refund of his initial copay. Two weeks ago, almost a year after his first visit, he received a refund check for $138 from a corporate "Patient Service Account"—a move he calls too little, too late.

"We are now in July of 2026. I think they're just a little bit too slow, and the arrogance of them not even responding to all my letters is just unbecoming." — Justin Turton, Patient

Daniels Modern Dentistry has similar complaints filed with the Better Business Bureau. According to Bryan Oglesby of the Better Business Bureau, "Daniel's Modern Dentistry currently shows that they carry an F rating with the Better Business Bureau for failure to respond to three complaints filed".

Chief WINK Investigates Reporter Chorus Nylander spoke with Janie McCarty, an elderly woman who describes an even more disruptive experience after visiting Fort Myers Modern Dentistry for a loose tooth. 

She believed she was agreeing to a $1,500 procedure. But internal records show an account was opened through the corporate network’s financing arm for more than $5,000 to cover a multi-stage implant plan. Janie says she had no idea a line of credit had been opened until her personal bank account was drained to cover her bills.

"When I returned and looked at my account, got ready to pay my bills for the month, there was no money... One day, I'm sitting here watching TV, and the light was turned off. That has never happened." — Janie McCarty, Patient

Industry Oversight and Corporate Response

The Florida Dental Association emphasizes that while corporate DSO networks handle the business side, state law dictates that licensed dentists must remain in full control of patient care and ethical standards. Fort Myers and Daniels Modern Dentistry both are owned by licensed dentists while receiving administrative management from PDS Health.

"The patient-dentist relationship is extremely crucial. The patient has to be able to trust the dentist. The dentist has to have the autonomy to evaluate, treatment plan, and then provide treatment." — Dr. Dan Gesick, Florida Dental Association President

WINK Investigates took these customer concerns directly to the parent support company, PDS Health, and the local clinics. Both offices pushed back fiercely against allegations of wrongdoing and unauthorized withdrawals.

PDS says "dental benefit plans function more like discounts off of treatment, and what a plan will or will not cover for a specific patient and procedure is determined by the payer after a claim is submitted, not at the time of treatment". They also note that whenever there's a discrepancy, the dental offices work with the patient for a resolution, which they maintain happened in these cases.

In Janie McCarty’s case, the clinic provided proof it did not directly draft her bank account. Instead, records show Janie independently authorized the $5,032 financing line via a multi-step text verification process on her phone. When she decided to cancel the future implant work, the clinic says it promptly refunded $3,306 back to her credit line. 

The dental office also says it advocated for Janie behind the scenes, fighting her medical insurance company for eight months. On July 6th, United Healthcare approved the claim, and on July 14th, the clinic overnighted Janie a check for over $1,700, completely wiping out her out-of-pocket costs.

As for Justin Turton, Daniels Modern Dentistry states the extra $400 he was asked to pay was simply an estimate presented for future maintenance care, which he declined and was never billed for. They noted his $138 check was a delayed refund for a prepaid saliva screening he never received. Justin remains firm: "I am going to be sending this check back to them". When asked if he wouldn't be accepting that check, he replied, "No".

Full Responses from PDS Health, Fort Myers Modern Dentistry, and Daniels Modern Dentistry

Statement from PDS Health:

“Large group dental practices and dental support organizations (DSOs) encompass a wide range of structures, ownership models and operational approaches. We respectfully ask that your reporting not generalize or make unfair assumptions about either practice, the practice owners, or PDS Health based on broader characterizations of the DSO industry.

PDS Health is an integrated healthcare support organization that partners with independently owned dental and primary care practices. We provide administrative and operational support, access to advanced and proven technologies, compliance resources, education and other services that allow clinicians to devote more time and attention to patient care.

PDS Health does not employ the treating clinicians and does not make patient diagnoses, develop treatment plans or direct clinical care. Those decisions are made solely by the licensed dentists who own and operate each practice, based on their professional judgment and the individual needs of their patients.

For patients, the supported-practice model can provide access to modern technology, same-day restorative care, digital imaging, specialty services and coordinated resources within the practice, allowing clinicians to be better equipped and better able to focus on patient care, alongside a clinical community built on peer mentorship, continuing education, and established programs designed to help practices provide consistent, high-quality care while maintaining full clinical independence.

Responses to Your Questions

• Question 1: What standard protocols are implemented by PDS Health to ensure that localized patient cost estimates strictly match centralized final billing statements, and how are regional discrepancies resolved?
  Response: This question reflects a common misunderstanding of how dental billing works that is worth clarifying for your viewers. Dental benefit plans are not like traditional health insurance. They function more like discounts off of treatment, and what a plan will or will not cover for a specific patient and procedure is determined by the payer after a claim is submitted, not at the time of treatment. Practices provide good faith cost estimates based on the patient's stated benefits and the information available at that time. Those estimates are not guarantees of final patient responsibility. Final costs may be affected by the patient's specific plan terms, deductibles, annual maximums, frequency limitations, prior treatment history, and payer adjudication decisions, all of which are outside the practice's control. The practices we work with have systems in place to submit claims accurately and assist patients in understanding their benefits. When a discrepancy arises between an estimate and a final statement, the practice reviews the account and works directly with the patient toward resolution. That is what happened in both of the cases you referenced.
• Question 2: What is the corporate policy regarding providing physical receipts, itemized cost breakdowns, and signed treatment plans to patients at the time of service?
  Response: It is standard practice across dentistry to present patients with treatment plans, cost estimates and financial arrangements prior to initiating treatment. Patients are asked to review and sign financial arrangements before care is provided. Those signed documents reflect the patient's acknowledgment of their estimated responsibility. In both cases referenced in your inquiry, signed financial arrangements are on file.
• Question 3: What verification and authorization mechanisms does the network utilize before processing direct withdrawals or pre-authorized drafts from a patient's personal bank account?
  Response: We want to address this directly and clearly: Fort Myers Modern Dentistry did not initiate or authorize any direct withdrawal from Ms. McCarty's personal bank account. We have found no evidence supporting that allegation, and our records do not reflect any such transaction. What did occur is that Ms. McCarty separately applied for and authorized a Smile Generation Financial/Comenity Bank financing account to cover her treatment plan. That authorization involved a multi-step process completed independently by Ms. McCarty. Comenity Bank financing is not a bank draft or direct withdrawal, it is a patient-authorized financing arrangement, similar to applying for and using a credit card account to cover planned medical expenses. Furthermore, our records confirmed directly with Comenity Bank show that Ms. McCarty herself attempted two separate payment transactions through the Comenity Bank portal, totaling $5,032, both of which were returned and did not successfully process. No funds were successfully withdrawn from her personal bank account in connection with those payment attempts. The practice did not withdraw, draft or debit any funds from her personal bank account at any time.
• Question 4: Does PDS Health offer or facilitate automated applications for third-party financing lines of credit during patient intake, and what steps are taken to prevent unrequested credit line generation?
  Response: Comenity Bank is one of several financing options made available to patients who choose to use it to cover treatment costs. It is not initiated automatically or without patient consent. As described in the statement from Fort Myers Modern Dentistry, the account opening process requires multiple independent patient authorizations. With respect to the Comenity card Ms. McCarty references: Smile Generation Financial is issued by Comenity Capital Bank. They are the same product. The card she describes as “unsolicited” is the Comenity Bank financing account she applied for and authorized at the time of her visit. It is not a separate or unrelated credit product.
• Question 5: What specific compliance measures or communication practices does your organization employ to ensure clarity and transparency for elderly patients?
  Response: Every patient, regardless of age, deserves a clear understanding of their treatment plan, estimated costs and financial obligations before care begins. We take that responsibility seriously. As an example of our long-standing commitment to our nation's elderly, PDS Health has been working toward the inclusion of medically necessary dental care in Medicare for nearly a decade. Not because the practices we support would financially benefit from it, but because we believe our nation's elderly deserve it. A coalition (which PDS Health initially founded and funded) of almost 250 national organizations, including AARP, are signed onto this effort. PDS Health has also joined the AgeTech Collaborative from AARP, the first non-startup dental-focused organization to do so, because we believe oral health is inseparable from healthy aging. Dental insurance and patient financing are genuinely complex, and we recognize that navigating them can be confusing. We fundamentally believe patients deserve to understand their oral healthcare and their financial obligations, clearly, completely and with patience. The clinicians we support see themselves as their patients' advocates. Collectively, we regret that either patient experienced confusion or financial stress in connection with their care, and we are working directly with both patients, offering resolution options to address their concerns.”

Statement from Fort Myers Modern Dentistry:

“The following statement is provided on behalf of Fort Myers Modern Dentistry, an independently owned dental practice operating in Southwest Florida. The practice is owned and operated by a licensed dentist who exercises sole and independent clinical judgment in the diagnosis, treatment planning, pricing and care of each patient. While PDS Health provides administrative and operational support to the practice, Fort Myers Modern Dentistry is a separate, independently owned clinical practice.

Like dental practices across the state and nation, Fort Myers Modern Dentistry strives to communicate costs and estimates clearly. Dental benefit plans vary widely, and what a plan will or will not cover is often not known until after a claim is submitted. Despite their best efforts miscommunications can occur, and when they do, the dentists and practice work directly with their patients and offer resolution options.

Relying on her signed HIPAA waiver, Fort Myers Modern Dentistry addresses the record directly with respect to Ms. McCarty.

It is important to understand from the outset that Ms. McCarty did not present for a simple tooth extraction. She presented as an emergency patient on October 27, 2025. Following her evaluation, the clinician reviewed Ms. McCarty's clinical findings and treatment options with her in detail. Based on that consultation, Ms. McCarty chose to proceed with the recommended course of care: a tooth extraction, bone graft, osteotomy, a dental implant, and an implant crown, to be completed in phases over time. This was an informed decision made by Ms. McCarty following a thorough clinical and financial review by our team.

Ms. McCarty executed a financial arrangement on October 27, 2025 for her extraction treatment. Our records reflect a signed financial arrangement for $1,726, not a $1,500 treatment plan as alleged.

Separately, Ms. McCarty applied for and authorized a Smile Generation Financial/Comenity Bank account. Smile Generation Financial is the name of a healthcare financing program issued and managed by Comenity Capital Bank that enables patients to pay for treatment over time. Ms. McCarty's account was opened in the amount of $5,032 to cover her full treatment plan. This was not a passive enrollment. Ms. McCarty completed a multi-step authorization process: she provided her identifying information to apply, received a text message asking whether she wished to proceed with the application and responded affirmatively, and received a second text message asking her to authorize the charge on her Comenity account and responded affirmatively. That authorization is documented, including her cell phone number stamped on the receipt in her chart. Following an extraction, it is standard practice for staff to provide the patient with a folder containing printed post-operative wound care instructions and related account/financing documentation, which was done at this visit.

Regarding the Comenity credit card Ms. McCarty describes as “unsolicited,” the card she references is the Comenity Bank financing account she applied for and authorized at the time of her visit to cover her treatment plan. It was not opened without her knowledge or consent.

Ms. McCarty returned for post-operative visits on November 4, November 14, and November 20, 2025. At her November 20 visit, her treating clinician documented that she was healing well and would be ready for her implant placement in January 2026.

In December 2025, Ms. McCarty met with our practice owner, who found her to be gracious and earnest in communicating her concerns. Ms. McCarty communicated that she did not wish to continue with the remainder of her treatment plan. At that point, a refund was initiated for the full amount charged for the future treatment she would not be completing (the implant, custom abutment and implant crown). That refund of $3,306 was processed and returned to Comenity Bank. Comenity Bank has confirmed that the $3,306 has been removed from Ms. McCarty's account balance.

Regarding the alleged $5,000 unauthorized withdrawal from her Sun Coast Credit Union account: we did not initiate or authorize any withdrawal from Ms. McCarty's personal bank account. The $5,032 she references was her Comenity Bank financing account, an account she applied for and authorized independently. Our records, confirmed directly with Comenity Bank, show that Ms. McCarty attempted two separate payments through the Comenity Bank portal, totaling $5,032, both of which were returned and did not successfully process. No funds were successfully withdrawn from her personal bank account in connection with those payment attempts. We understand that Ms. McCarty experienced significant financial hardship, and our heart goes out to her. Based on our records and direct confirmation from Comenity Bank, those transactions were initiated by Ms. McCarty through the Comenity Bank portal, not by our practice. We did not withdraw, draft or debit any funds from her personal bank account at any time. If Ms. McCarty is experiencing difficulties with Comenity Bank, please let us know so that we can also advocate for a speedy and positive resolution on her behalf.

Regarding the changing balance statements from a collection agency: as you confirmed, “Great Expectations” was an error in your original inquiry. The financing entity is Comenity Bank, consistent with our records. We have confirmed that our practice did not place Ms. McCarty's account with any collection agency. We have also confirmed with Comenity Bank directly that they did not initiate any collection activity on her account.

We also want to share important context that speaks directly to our commitment to patient advocacy. At the time Ms. McCarty agreed to her treatment plan, we requested her medical insurance information and proactively submitted her treatment to her medical insurer, United Healthcare Commercial, on her behalf. Our goal is to minimize, wherever possible, what patients pay out of pocket. By coordinating both her dental and medical coverage, we worked to ensure Ms. McCarty received the full benefit of every plan available to her. We first submitted the claim electronically on October 31, 2025, and when that submission was rejected due to an administrative issue with the provider file, we followed up with a paper submission on November 7, 2025. The practice continued to pursue the claim through December 2025 and again in April 2026, working persistently on Ms. McCarty's behalf over the course of eight months. That claim was ultimately approved, with payment received on July 6, 2026. After receipt of these funds, we refunded Ms. McCarty her full $1,726 out-of-pocket payment directly to her by check. The refund of $1,726 was issued directly to Ms. McCarty on July 14, 2026 and sent via FedEx Overnight. Our efforts eliminated her out-of-pocket costs entirely.

We have documentation supporting every claim made above and are prepared to provide it to you immediately pursuant to the patient authorizations already received. Please let us know and we will make it available without delay.

We care deeply for our patients and regret that Ms. McCarty experienced confusion or financial stress in connection with her care. We take that seriously, and we are working directly with her, offering resolution options to address her concerns.”

“Ms. McCarty came to us as an emergency patient, and from that first visit, her health and well-being were our priority. We proactively worked to identify every possible avenue to support her, including submitting her treatment to her medical insurance on her behalf. I am committed to making sure she feels heard and that this is resolved to her satisfaction.” — Kelsey Archer, DMD, practice owner, Fort Myers Modern Dentistry

Statement from Daniels Modern Dentistry:

“The following statement is provided on behalf of Daniels Modern Dentistry, an independently owned dental practice operating in Southwest Florida. The practice is owned and operated by a licensed dentist who exercises sole and independent clinical judgment in the diagnosis, treatment planning, pricing and care of each patient. While PDS Health provides administrative and operational support to the practice, Daniels Modern Dentistry is a separate, independently owned clinical practice.

Like dental practices across the state and nation, Daniels Modern Dentistry strives to communicate costs and estimates clearly. Dental benefit plans vary widely, and what a plan will or will not cover is often not known until after a claim is submitted. Despite their best efforts, miscommunications can occur, and when they do, the dentists and practice work directly with their patients and offer resolution options.

Relying on his signed HIPAA waiver, Daniels Modern Dentistry addresses the record directly with respect to Mr. Turton.

Mr. Turton presented to our practice on August 4, 2025, for a new patient visit. Based on his clinical evaluation, his treating clinician diagnosed periodontal disease and recommended scaling and root planing (SRP) therapy. Patients diagnosed with periodontal disease typically require treatment of the disease rather than a more routine preventive cleaning. Accordingly, Mr. Turton received SRP therapy, which was the clinically appropriate treatment based on his periodontal health.

Prior to treatment, Mr. Turton executed a financial arrangement acknowledging his estimated patient responsibility (also called his “out-of-pocket”) and paid $1,037 at the time of service. As is required of all dental practices, we submitted a claim to his dental benefit plan for the treatment rendered during that visit. That submission of those procedures totaled $4,610, what is referred to as the “usual and customary charge,” meaning the provider's standard fee for those procedures. This is all done in accordance with dental plan rules; practices are required to bill a patient's benefit plan on all claims regardless of expected reimbursement. This is standard practice across the dental and medical insurance industry. It was not a charge to Mr. Turton. His out-of-pocket responsibility was $1,037, as agreed.

At that same visit, Mr. Turton also prepaid $138 for two upcoming services: a saliva screening and a consultation with the periodontist, which was scheduled for a future visit.

When Mr. Turton returned on December 1, 2025, he met with the dental hygienist and was presented with a treatment plan for his periodontal maintenance visit. He chose not to move forward with those services that day. Because he did not proceed, no charges were applied for that visit. The approximately $400 he references reflects the cost of services he was presented but declined, not charges he incurred.

Upon reviewing his account earlier this year, we identified that the $138 prepayment had not been returned to him at the time of his December visit, as it should have been. A refund of $138 was then issued to Mr. Turton in June 2026. That refund check was sent to him and remains uncashed.

Regarding Mr. Turton's written correspondence: our office staff have no record of receiving a registered letter or any written correspondence from Mr. Turton.

Our documentation does not support the allegation that Mr. Turton was billed for services not performed. We remain committed to resolving his concerns directly and welcome the opportunity to do so.”

“Every patient who walks through our door deserves our full attention and honest best. I regret that Mr. Turton left without a clear understanding of his care and his account, and I would welcome the opportunity to speak with him directly and make it right.” — Andres Cruz, DMD, practice owner, Daniels Modern Dentistry

If you have a story you’d like WINK Investigates to look into, email us at winkinvestigates@winknews.com or call our tip line at 239-344-5074.