Author Topic: Dental [Billing] Deception - Need Advice Please  (Read 4750 times)

MrsCoolCat

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Dental [Billing] Deception - Need Advice Please
« on: August 11, 2016, 07:21:27 AM »
I am so livid right now. A dentist showed up as in-network but was at a facility. I've never been to one before. I waited almost an hour for a standard & may I say brief teeth cleaning. Prior to the 45min wait the woman at the front desk said all I owed her was $50 because that was my deductible.

Now I check online & they charged me for an out of network dentist bc according to the UHC rep when providers see u have a PPO that accepts out of network providers they still accept u (for obvious reasons). This facility/office was like 3 miles from my house. After the fact I know they're a bunch of criminals but common sense WHY the flying f**k would I pay for an out of network provider 10min from my house, wait 45min AND be subject to a shitty standard cleaning?! I am so mad right now. I didn't know I had to make sure they only scheduled & charged me for the in network provider bc I thought it was a given...

So bottom line. My claim says I owe them $217. How much will this effect my credit (780s) if I tell them to FUCK themselves & lick my @$$?! Because I am so livid I am seriously considering. Apparently I can appeal but I doubt that sounds successful. Oh and they charged me for fluoride which apparently costs $80 bc I'm over 14! And this $50 deductible I paid wasn't even documented on the claim. I def have that receipt but wtf?!

Mustachians, please tell me the worse case scenario if I just refuse to pay, do the appeal etc. or wtf should I do? Words cannot even express right now. I'm thinking about doing a chargeback on the $50 deductible on my credit card, too... Idk I'm so upset that I'm really just not thinking logically.
« Last Edit: August 11, 2016, 07:53:43 AM by MrsCoolCat »

driftwood

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Re: Dental Deception
« Reply #1 on: August 11, 2016, 07:43:51 AM »
... sense WHY the flying f**k would I pay for an out of network provider 10min from my house, wait 45min AND be subject to a shitty standard cleaning?!

How much will this effect my credit (780s) if I tell them to FUCK themselves & lick my @$$?!

I don't have an answer but I enjoyed the profanity!

catccc

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #2 on: August 11, 2016, 08:17:24 AM »
What does it mean that the dentist was in-network but at a facility?  If you searched your insurance site and saw that the dentist was listed, that doesn't necessarily mean they are in-network.  If you have proof that the doctor is in-network, I think you need to talk to your insurance company.

What is the deductible for your plan?  For dental, in my experience, it is usually a small deductible for the year, not per service.

bye-bye Ms. FancyPants

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #3 on: August 11, 2016, 08:23:38 AM »
I don't know how it will affect your credit, I just wanted to say I'm sorry, that sucks!!! I swear, I can't tell you how many shady dentists I have met in my lifetime. I almost expect the insurance companies to try to screw me, but I still find the attempted screwing by medical professionals surprising. Just another for profit business, smh.

And I would try to appeal it. I'm assuming they are saying the facility which the dentist saw you was out of network, not the dentist themselves? If that's the case, you should only be paying out of network fee for the facility, not the dentist. I know it doesn't help you now, but for future reference, most plans don't cover fluoride treatments :/

boarder42

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #4 on: August 11, 2016, 08:27:41 AM »
not sure on the dentist stuff

but no matter the fee your credit will be destoryed b/c you will be reported to a collection agency as being in default and even when you pay it off it will haunt you for 7 years.

ignoring a bill you dont think you owe doesnt mean you dont owe it.  This was my wife's solution to a landlord trying to charge her 200 bucks for a cleaning fee that should have been part of the security deposit.  YOU CANT JUST IGNORE SHIT

either actively pursue it thru your insurance to see what happened so you dont make the mistake againg.  and learn your lesson.  or go find a lawyer.  but you cant just not pay it.
« Last Edit: August 11, 2016, 08:29:19 AM by boarder42 »

SKL-HOU

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #5 on: August 11, 2016, 08:38:06 AM »
Did you talk to your insurance? One time an ambulance service tried to charge me for the difference between what insurance paid them (and has a deal with) and what they billed for. I told the insurance company and the lady said they cannot do that because it is their contract rate and they can get kicked off the plan and she took care of it for me immediately. I wonder if something similar is going on.
With my dental insurance, I never have to worry about anything. The only thing I paid out of pocket is for my son's fluoride for $12 for some reason (and that was only at one dentist). I switched him to my dentist and now neither of us pay. We get cleaning twice a year and xrays at certain intervals (I think once a year for simple and every 5 years for extensive). It was the same with my previous employer's plan.

Cycling Stache

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #6 on: August 11, 2016, 08:45:27 AM »
I am so livid right now. A dentist showed up as in-network but was at a facility. I've never been to one before. I waited almost an hour for a standard & may I say brief teeth cleaning. Prior to the 45min wait the woman at the front desk said all I owed her was $50 because that was my deductible.

Now I check online & they charged me for an out of network dentist bc according to the UHC rep when providers see u have a PPO that accepts out of network providers they still accept u (for obvious reasons). This facility/office was like 3 miles from my house. After the fact I know they're a bunch of criminals but common sense WHY the flying f**k would I pay for an out of network provider 10min from my house, wait 45min AND be subject to a shitty standard cleaning?! I am so mad right now. I didn't know I had to make sure they only scheduled & charged me for the in network provider bc I thought it was a given...

So bottom line. My claim says I owe them $217. How much will this effect my credit (780s) if I tell them to FUCK themselves & lick my @$$?! Because I am so livid I am seriously considering. Apparently I can appeal but I doubt that sounds successful. Oh and they charged me for fluoride which apparently costs $80 bc I'm over 14! And this $50 deductible I paid wasn't even documented on the claim. I def have that receipt but wtf?!

Mustachians, please tell me the worse case scenario if I just refuse to pay, do the appeal etc. or wtf should I do? Words cannot even express right now. I'm thinking about doing a chargeback on the $50 deductible on my credit card, too... Idk I'm so upset that I'm really just not thinking logically.

Sucks, and I don't have advice, although I suspect that the general answer will be challenge it, then pay it, because you care about your credit more than they do.  FYI, you can also challenge the place that billed you once you're done with the insurance company, and maybe that place will make some accommodation.

I wanted to respond though because I've had a very similar situation happen with an emergency room visit, and that is a high dollar issue.  I have probably the most widely accepted insurance plan with the most providers in the United States (thanks, federal government).  When I hurt my shoulder badly, but no so badly that I couldn't get a ride to 10 other emergency rooms within a 15 mile radius, i went to the local emergency room.  They told me they were a provider and it was covered (although they at first didn't want to commit until they had admitted me).  I told them I wasn't walking through the door until I got a firm answer because I could go to 10 other places.

That time, everything worked out.  Fast forward 3 years later, and I had a similar accident.  I went to the same place, same insurance, and had the same stand off with them about not walking through the door until I got a final answer.  Then I get a bill for close to $1,000.

What happened?  Apparently, just because the hospital and emergency room are preferred providers does not mean that everyone who might be there is a preferred provider.  So, some doctor walks into your room while you're there, the X-ray tech looking at the films while you're there, if any of those people are not also preferred providers, you're paying their full bill.

I called my insurance company livid because, as I told them, I didn't know what further steps I could have taken to ensure that my insurance covered it, and there were covered medical providers everywhere so what could I do to make sure that I saw any one of those providers.  They told me nothing, and the bill only got adjusted because the doctor in question applied to become a provider for my insurance retroactively.  And the insurance company was very clear that if he had not become a provider, I would have been responsible for the bill.

That situation is ridiculous.  I've talked to a bunch of people about it, and some say that you have to basically challenge any person who tries to walk into the room to see if they're a provider for your insurance (a little tough if you're in bad shape, by the way), and that still doesn't cover someone in the back doing lab work or X-rays or something.

In any event, I realized I just hijacked the thread, but when I read what happened to you, it reminded me of that incident and how helpless I felt to get my insurance to cover something that--if anyone had given me straight information up front--I could have found any number of providers that would have been covered.

Ugh.


I'm a red panda

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #7 on: August 11, 2016, 08:58:24 AM »
I would not wreck my credit for $217.

brute

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #8 on: August 11, 2016, 09:00:20 AM »
I would not wreck my credit for $217.

Ditto.

frugaliknowit

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #9 on: August 11, 2016, 09:07:56 AM »
My only advise is that unless your employer is subsidizing (i.e. throwing actual money toward your premium) your dental insurance, dental insurance is pure SMOKE AND MIRRORS!  If you break it down, at best it is nothing better than a budgeting tool for dental work, certainly no better than putting some funds in an emergency fund or other savings account to pay for dental work over time.

If you fully analyze it, what are you insuring?  Typically $1,000 maximum per year with copays and deductibles and it doesn't cover implants.  Why bother...self insure.

I dumped my so called insurance several years ago.  I can negotiate and shop cleanings and anything else I need.

mskyle

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #10 on: August 11, 2016, 09:21:37 AM »
Also, leave a good polite but furious yelp review for the dentist (calmer than this post, ideally :P). This is the kind of thing I would want to know about.

But ultimately, yeah, $217 is not worth a derogatory mark on your credit report.

plog

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #11 on: August 11, 2016, 09:30:05 AM »
Quote
if I tell them to FUCK themselves & lick my @$$?!

That is some odd self-censoring cursing. 

I disagree with everyone else and say fuck them in their gosh darn tushies.  It's a gamble, but the risk/reward is too great to pass up.

I'm certain the dentist has a collection agency which your case will be refered to.  Yes, there will be calls and letters, but you get to tell those fuckwads to kiss your heiney and basically fuck with them. Now, the rest is uncertain.  It is possible you could get a ding on your credit report, maybe its even likely, but I don't think its a certainty.  Not everyone reports to the bureaus, especially small businesses.  Another possibility is being sued, but that's not a certainty either.  The amount they say you owe, probably isn't worth it to them to file.  Most likely they sell the debt and it just follows you for a few years.  As it gets older the less it hurts your credit.  Plus the balance of the deliquency comes into play with your credit score as well and this isn't a big balance-- I don't think the ding is going to be that big to begin with. 

I really don't think the downside is that great and upside will feel good.  So I vote you tell those motherfuckers to eat doodie. 
« Last Edit: August 11, 2016, 09:32:41 AM by plog »

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #12 on: August 11, 2016, 09:38:32 AM »
How many points or how exactly will it affect my credit score? I will seriously send them $2 a month if it was up to me. I do plenty of Mystery Shops to accommodate for postage. Hell, I'll even drop it off myself.

Oh if they can't/don't resolve this I will most definitely (and tell them) that I will blast them in every available social media forum available from here to kingdom come, and in very legit details. Yelp, ZocDoc, Facebook, the UHC website & wherever they are affiliated with via reviews.

When I called and so bluntly told them bc I literally had no other words... They said the Office Manager comes in later & she will ask if they can reroute the claim somehow if possible... Does anyone know if this is even possible? I won't hold my breath but I'll wait and see.
« Last Edit: August 11, 2016, 09:40:33 AM by MrsCoolCat »

bye-bye Ms. FancyPants

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #13 on: August 11, 2016, 09:47:30 AM »
Quote
if I tell them to FUCK themselves & lick my @$$?!

That is some odd self-censoring cursing. 

I disagree with everyone else and say fuck them in their gosh darn tushies.  It's a gamble, but the risk/reward is too great to pass up. 

I really don't think the downside is that great and upside will feel good.  So I vote you tell those motherfuckers to eat doodie.

^^^^ LMAO! ^^^^ 

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #14 on: August 11, 2016, 09:55:56 AM »
Facility I guess just meant they have hordes of other dentists that are not in network but just swarming around like locusts/leeches... I did talk to my insurance. They told me I have to ensure the dentist is in network when it's a large facility and the insurance was the one that told me when they see u have a PPO & have out of network coverage they take you. Where was I to be notified of this?

I literally told the dental billing office that I had an appt with the in network provided at 1:15pm which I rescheduled bc she gave me the, "Oh, there weren't any in-network dentists at the time that u came in..." Excuse me? Wouldn't this information have been better provided to me before u crooks checked me in? Hell, I would have left after the 45min wait. And who the freak can't verify & tell me ur out of network after making me wait 45min? Wtf were u doing & "confirming"?!

Kroaler

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #15 on: August 11, 2016, 10:26:06 AM »
Where are these mega dental clinics you speak of?

My current dentist used to work in a cotton mill before going to dental school.  Small mom and pop shop.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #16 on: August 11, 2016, 10:29:41 AM »
I disagree with everyone else and say fuck them in their gosh darn tushies.  It's a gamble, but the risk/reward is too great to pass up.

... I'm to tell those fuckwads to kiss your heiney and basically fuck with them. Now,
I really don't think the downside is that great and upside will feel good.  So I vote you tell those motherfuckers to eat doodie.

http://www.forbes.com/sites/christinalamontagne/2014/08/26/medical-debts-will-soon-weigh-less-on-your-credit-score-but-theyre-still-a-problem/#17fa2ad61343

I feel very deceived by them and the costs are ridiculous esp for out of network. Not mentioned even once. Plus the wrong information about $50 is all I have to pay? Really?

For 25 points & I can have the pleasure of a fuck you with two middle fingers AND both my middle toes? I will def do it. I need to do more research. I might call Experian if this doesn't pan out bc well, when I rescheduled my appt I assume it's still in network. Also, the front desk lady specifically told me I just have to pay a $50 deductible per calendar year... Yeah either she's an idiot or a con artist. Which is it?
« Last Edit: August 11, 2016, 10:36:32 AM by MrsCoolCat »

boarder42

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #17 on: August 11, 2016, 10:31:00 AM »
How many points or how exactly will it affect my credit score? I will seriously send them $2 a month if it was up to me. I do plenty of Mystery Shops to accommodate for postage. Hell, I'll even drop it off myself.

Oh if they can't/don't resolve this I will most definitely (and tell them) that I will blast them in every available social media forum available from here to kingdom come, and in very legit details. Yelp, ZocDoc, Facebook, the UHC website & wherever they are affiliated with via reviews.

When I called and so bluntly told them bc I literally had no other words... They said the Office Manager comes in later & she will ask if they can reroute the claim somehow if possible... Does anyone know if this is even possible? I won't hold my breath but I'll wait and see.

did you read my post above.. it will destroy your credit.. this isnt something to play games with ... blaming them is a complainy pants excuse way out of it. end of the day YOU F'd up partially and are at fault... take the 217 dollar mistake as a learning lesson and move on.  or be more civil about it and try to get it reduced either way learn and move on.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #18 on: August 11, 2016, 10:53:35 AM »
Insurance / billing confusion is way more common than it should be.  Here's what I suggest:

Wait for the dentist to bill you, then call them to complain.  They will send you to the insurance company at that stage, where you can complain to them.  They will send you back to the dentist, etc.  With any luck, the insurance company will pay up, or the dentist will reduce their charge.  In any case this back and forth can go on for weeks or months. 

When you talk to the insurance company, explain that it appeared to be in network and you thought your copay was $50 and that's what you'd be happy to pay (in fact already paid).   Ask (nicely) if there's anything they can do to help with this issue.

When you talk to the dentist, tell them the billing issue as it appears both you and the dentist had incorrect info about what the insurance payment would be.  Maybe they are willing to reduce the bill for this visit.

Repeat the process as needed until successful or you're tired of it and just pay the remaining bill.  With the insurance company you will get a different rep each time you call and you might get lucky with one.  The key to resolving this in your favor is to be polite and not give up.

Eventually if you do not resolve and don't pay, the dentist may send the bill off to collections.  This probably won't occur until 90 days and about 3 statements mailed home.

Any suggestions on how to sound nice, sane & normal? Unfortunately, I'm a pessimist and shut down when unfair situations occur and my tone really doesn't hide it well either. I just think worst case scenario and can't seem to sound endearing for the life of me. After all they're pretty much fucking with my money and time.

Jack

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #19 on: August 11, 2016, 11:01:43 AM »
did you read my post above.. it will destroy your credit..

Maybe she did read it, but disagrees with your bombastic hyperbole and your insinuation that said disagreement must equate to ignorance. I sure as fuck do!

The fact is, one collection action won't necessarily "destroy your credit." I know this because I have a collection action on my credit for the same reason as the OP, and my credit is still good.

end of the day YOU F'd up partially and are at fault...

Lies of omission are still lies. At the "end of the day," the OP was led to believe that the services were in-network. Morally and ethically speaking, it should not be the obligation of every innocent patient, untrained in medical bookkeeping, to actively and competently defend themselves from the intentional conspiracy of medical practices/insurance companies to make staying in-network as difficult as possible!

be more civil about it

Pot, meet kettle.

ZiziPB

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #20 on: August 11, 2016, 11:03:14 AM »
I think it would be helpful if you actually explained what exactly happened because I can't make any sense of your rant.

So you went to a dentist that you thought was in-network but it turned out to be out of network?  Does your insurance have any coverage for out of network services?  Typically, they allow you to see out of network providers but cover just a portion of the cost. Have you checked with the insurance company what portion of that bill (if any) they will cover?  Have you talked to the billing department at the dental clinic to see what they can do? 

jim555

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #21 on: August 11, 2016, 12:03:35 PM »
I had an eye doctor tell me they were in network.  After several visits they come out with they are not in network.  So eventually they settled with me for a much smaller amount after I chewed them out.  Settling is probably your best move.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #22 on: August 11, 2016, 12:04:25 PM »
Again I would recommend waiting for the actual bill from the dentist in this case because sometimes they reduce the total or even accept what the insurance company offered as full payment.

Is this truly advisable given the timeframe that my appt was last Friday, 08/05? I only ask bc the billing asst said she'd ask the Office Manager if they could reroute the billing codes, SO as me taking responsibility going forward I was wondering if they have a timeframe in which to do that? So do I needed to harass them now to maybe change the coding or who.sent it, and try to explain the whole situation... Nicely or at least ignorant/naive bc that seems to work better for me than pissed and idk if I can remain "calm"...

Thank you everyone.
« Last Edit: August 11, 2016, 12:44:51 PM by MrsCoolCat »

Kroaler

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #23 on: August 11, 2016, 12:13:00 PM »
"Its easier to catch flies with honey"  Niceness always seems to go farther

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #24 on: August 11, 2016, 12:43:59 PM »
Okay everyone, so I'm taking the Office Managers' word for this but she said there was a billing code mistake, and even though it was an out of network dentist that saw me they do a courtesy for their patients bc of the billing error, miscommunication or whatever it was that unfolded. She also refunded my $50.

I want to thank everyone. I did remember to try & be as nice as I could, but prob came off more as just ignorant-ish than nice, but remained cool. I guess it worked out but I will wait to see it in writing or on my UHC website. Anyways, I always knew there were huge issues with billing but I rarely ever go to doctors or had this problem before, so yes, I did learn some things.

I do wish things were a lot more obvious & transparent but going forward I'll probably sound crazy anal when I'm double checking, repeating & trying to reconfirm every doctor/billing related issue bc this & this happens often & from past experiences... It sucks to be so jaded, but I consider that how I learned.
« Last Edit: August 11, 2016, 12:46:13 PM by MrsCoolCat »

HipGnosis

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #25 on: August 11, 2016, 12:53:17 PM »
Mega Dr/DDS clinics are the McDonalds of health care.
Everyone there, and in all their corporate and support offices are just there for the job.

Challenge/contest the bill at every level.
With the clinic billing office (which is totally separate from the Dentist). 
With the insurance if it gets to them.
With the bill that gets mailed to you - Clark Howard.com use to have templates to use to write contest bill letters.
With collections - see above for templates
Ask to speak to a manager at every interaction.
Keep a log of the process.

Unless you're buying a house or re-financing soon, I wouldn't pay it.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #26 on: August 11, 2016, 01:30:38 PM »
Lol to the above about not paying it. Though my situation is technically "over" pending written documentation I agree to ppl that say fight/look into. I HATE having to deal with any type of billing issue, but I don't go down without a word & a fight. I may have jumped to conclusions with my worst case scenarios, but it's research & learning to me. Minus the standoffish tone that I do need help with controlling, who truly knows if things would have turned out differently if I waited for the bill & maybe they can't overturn or redo their billing codes by that point. Plus the research on the credit score was interesting.

I was proactive and I still kinda wish I can educate myself on if there was a timeframe to rebill and do these types "courtesy billings" happen often bc of incompetance & to appease those that actually question it. I'm just curious as to the screw ups behind the scenes, but can continue on with my life not knowing. God knows I'll prob have to deal with billing issues again in the future for my kids, etc.
« Last Edit: August 11, 2016, 01:46:13 PM by MrsCoolCat »

bacchi

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #27 on: August 11, 2016, 01:54:45 PM »
This is called "balance billing" and is illegal or restricted in many states, depending on the setting and care.

http://kff.org/private-insurance/issue-brief/surprise-medical-bills/

If it wasn't restricted, say because it was a DDS instead of an MD, I would've also been tempted to tell them to go fuck themselves.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #28 on: August 12, 2016, 07:48:42 AM »
So thank you everyone that commented. For anyone following this thread & cares to know about more details. I went back on the UHC website. Same $217 balance. I also noticed it said the claim was processed though honestly it was probably processed within 24hrs of submission & I didn't notice the status.

Anyways, so I called UHC. Asked them about the $217 & how the Office Manager said she would fix it, as a courtesy they would "reroute/redo" it as an in-network since there was a billing issue confusion, I didn't add that the OM apologized and literally said to me, "Don't worry about it, honey," yes, I live in SoFla, honey.

Anyways, so the UHC rep said that the insurance company already paid their portion. It's up to the dental office if they will bill you or not. She confirmed my suspicions that the dental office doesn't make more from the insurance company (since they have negotiated rates) when they charge out of network codes/billing but the cost difference is higher bc they bill the member/patient the difference that wasn't covered.

I know this seems like common sense, but it helped me understand why the OM told me not to worry about it. It seems to me they just won't get their "bonus" from me for billing out if network but it's not like their dentist was underpaid or not paid.

God I really hope they don't bill for the fluoride that they never told me they were putting on me. This has never happened before where a dentist just blatantly does procedures for extra insurance money AND didn't even bother to mention what it is they're applying...

The rep even said she always ask bc of these situations. Jesus, do I have to monitor & question every healthcare provider on their every move. What happened to trust or the courtesy of telling you wtf is going on...
« Last Edit: August 12, 2016, 07:54:32 AM by MrsCoolCat »

catccc

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #29 on: August 12, 2016, 07:53:46 AM »
This is called "balance billing" and is illegal or restricted in many states, depending on the setting and care.

http://kff.org/private-insurance/issue-brief/surprise-medical-bills/

If it wasn't restricted, say because it was a DDS instead of an MD, I would've also been tempted to tell them to go fuck themselves.

Balance billing (which I assume is legal where I am... maybe I should check) is what kills me in terms of dental bills.  For those that require significant dental work, employer subsidized insurance is a huge help.  Even individually paid insurance is a deal for me, and right now I carry both.  Which is really complicated, when you are the primary insured on both plans, and one is group and one is individual.  The office staff at my dentist's office is currently jumping through hoops to get this insurance stuff processed for me.  Insurance billing is amazingly complicated, and the balance billing for out of network providers is my biggest annoyance- but I really trust my dentist and it's office staff, so I am hesitant to go elsewhere, having had prior experiences that were unsatisfactory. 

I agree with the "wait until the dentist bills you," too.  It depends on the dentist on whether they make you pay up front or just bill you have all insurance has been processed.  But I would never pay my dentist based on an EOB that says I owe the dentist $x.  I would wait for a bill from the dentist, make sure it matches my EOB, and then pay.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #30 on: August 12, 2016, 08:21:05 AM »
Is this truly advisable given the timeframe that my appt was last Friday, 08/05? I only ask bc the billing asst said she'd ask the Office Manager if they could reroute the billing codes, SO as me taking responsibility going forward I was wondering if they have a timeframe in which to do that?
Good question - maybe you're doing the right thing there.

So I guess it doesn't matter bc the claims are processed pretty quickly? The only difference I see is you can have the OM research the situation among her staff now as opposed to trying to remember a month + from now when ur billed. Regardless, if they have a shit billing dept or system u can still get mailed a bill that was already resolved, thus still needing to call back & fix the situation... What hassle.

I know this from experience with getting repeated bills that have to be ignored. I almost wonder if it's to see who doesn't keep track & accidentally pays it. That or they're targeting elderly with bad memory vulnerable to pay...
« Last Edit: August 12, 2016, 08:26:17 AM by MrsCoolCat »

jeep69

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #31 on: August 19, 2016, 09:47:53 PM »
I'm a dental student and the insurance game sucks for sure. 

However I would have simply let you off the hook if you called in to my office and used those phrases above when talking to the receptionist as I don't hink I have laughed that hard all week. :)

LeRainDrop

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #32 on: August 19, 2016, 10:10:50 PM »
That really @!*)$*#& sucks!  Fluoride isn't covered on my plan either, but my dentist only charges $20.

Tom Bri

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #33 on: August 19, 2016, 10:32:25 PM »
I worked 5 years for a dental insurance company, and I think I understand what happened.
If the dentist is in network at one office, but you saw him at a different facility than he is registered at with the network, that still counts as Out Of Network!
Or, it could simply be an insurance company error. That happens all the time. Call the insurance company and ask them to check the dentist's name against the address of the facility you went to. It may take a bit of going back and forth, but that kind of error is easy to fix.
It sounds like everything is working out, and the dentist will waive the difference. That is what my dentist does. He takes whatever the insurance pays as OON, and then bills us as if INN. Good guy.

Frankies Girl

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #34 on: August 19, 2016, 10:45:53 PM »
My dentist will charge the insurance $20 for the fluoride, but if they know that insurance won't cover it and charge the patient, they don't even bother putting the charge on any billing. I was told that they'd rather eat the cost of the fluoride treatment than have their patients not get it because they feel that adults need it as much as kids (most insurance won't cover fluoride over the age of 12 I believe they said).

They also don't charge for basic xrays, and they give substantial discounts for non-insured patients.


Glad things worked out, but I'm also glad to confirm my dentist is as awesome as I thought.

MrsCoolCat

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #35 on: August 21, 2016, 06:36:59 PM »
Thanks everyone. No bill so far yet, but it is still kinda early. Yea, I've never had this issue with a dentist before...

tallen

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #36 on: August 22, 2016, 09:28:25 AM »
I had a dentist bill me for a bunch of extra xrays they decided to take in order to jack up my bill (went in for cleaning and check up which my ins. at the time covered and got a bill for several hundred dollars because of all the xrays they took that fell outside of what was covered and didn't inform me when they did it). I ended up filing a complaint with the BBB and the FTC and the dentist had to drop the charges.

Tom Bri

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #37 on: August 22, 2016, 08:07:34 PM »
I had a dentist bill me for a bunch of extra xrays they decided to take in order to jack up my bill (went in for cleaning and check up which my ins. at the time covered and got a bill for several hundred dollars because of all the xrays they took that fell outside of what was covered and didn't inform me when they did it). I ended up filing a complaint with the BBB and the FTC and the dentist had to drop the charges.

Dentists (and doctors) often don't know what is covered by insurance. They go with what they think you need and hope it is covered. My prior doctor had no idea what was and wasn't covered under Obamacare, and ordered a bunch of tests that I was supposed to pay for. The second year I went in and told them I only wanted what was covered under obamacare, and they still screwed it up. They did waive the extra charges, eventually.

Zamboni

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Re: Dental [Billing] Deception - Need Advice Please
« Reply #38 on: August 22, 2016, 08:59:46 PM »
I've only had something like this come up a couple of times, but my advice would be to send a signed letter (as in snail mail) writing that you dispute these charges. Keep a signed copy for yourself as well. If it does go to collections, send them the "these charges are in dispute" letter as well the first time they contact you.

It's a small amount and I doubt it will ruin your credit as long as you stay on top of it with rebuttal letters of dispute. No, you don't just have to pay any random bill you are sent for fear of wrecking your credit score! They will probably give up before you do.