Fighting Dentist Bill

[Mears]

I had an emergency earlier this year where a tooth broke in half over the weekend, and I needed to get to the dentist asap. I called my insurance company to find a new dentist to get in that Monday. One of the places they gave me is real close to my house. Turns out it was a new place that had just opened and they were able to get me in that same day. I had them fix that tooth, and during the visit they found a cavity and a chipped filling. They also put together a treatment plan to get rid of all my metal fillings, which I didn't go for. Anyways on the second visit to get a cleaning, have the cavity filled and, and the one filling replaced, they had the office lady break down the charges. I was absolutely floored at what my out of pocket expense was going to be. This office doesn't work with amalgam fillings and since the two new fillings were multi-surface they couldn't use the white composite. So I had to go with a porcelain inlay and onlay. It was somewhere between $700-900 for the pair plus what my insurance was supposed to cover. Against my better judgement, I agreed to the treatment. Mostly because I'm more lazy than cheap.

So that was a couple months ago. Last week, I get a message from the dentist saying that my insurance declined $800 in treatment. The guy even said on the voicemail that he'd be willing to meet me half way. That immediately set off alarm bells in my head. So I call my insurance company to figure out what the hell is going on. They tell me they declined the inlay and onlay because my plan only covers amalgam fillings. I then informed the representative that when the office that they recommended broke down the charges, I was told that my insurance company would cover roughly half of it. She said that she's not sure how they came to that conclusion since it's clearly outlined in my schedule <some word here> that they only cover metal fillings. I pressed her and asked that if my dentist told me that my insurance company would cover part of the treatment, did they make a mistake. To which she replied, yes they did.

Of course all of the paperwork I signed at the time of the treatment, said that I understood that insurance coverage was an estimate and I'm ultimately responsible, etc, etc, etc. However, if my dentist screwed up and misrepresented my insurance coverage, intentional or not, I don't want to pay a penny, let alone meet half way on $800. There is no way in hell I would have paid $400-$800 more on top of what was already a ridiculous sum for what should have been a couple fillings. Thoughts?

 

[randomrogue]

Going to the dentist is always expensive.

You can either pay it or go to small claims court. You choose. If it's any consolation you're getting off pretty cheap for all that work.

 

[Rumpltzer]

I think that the salutation for a dentist is "Dr. Bill" and not "Dentist Bill".


I'd have trouble fighting my dentist; he's kind of old, and I'd feel bad. I wouldn't mind wrestling with his dental assistant!

 

[tcG]

If it makes you feel any better, if you got porcelain inlays/onlays you got some good-ass fillings. Those will last longer and don't leach bad stuff into your mouth like composites or mercury amalgams. The only thing better are gold onlays.

 

[OCGuy]

Let all of your debts go, file bankruptsy, start building credit. In 4 years you can buy whatever you want again.

It is the American way.

You can't BK out of government debt (taxes, student loans, etc), but the SMART people transfer their government debt to a CC and then BK.

 

[SagaLore]

only covers amalgam fillings.... that they only cover metal fillings

Ewww. Get new insurance? :\

 

[Mears]

Ewww. Get new insurance? :\

Maybe I didn't state that correctly. They do cover crowns (which I originally got for the broken tooth), root canals, etc, etc. However, the cavity and filling I had replaced would typically be replaced with a metal filling. That's the "reasonable and customary" treatment.

Yes, I realize I got some "nice fillings". And I paid for them. In the past, my out of pocket for a filling was in the $20-$80 range. This was many times that amount.

 

[AznAnarchy99]

Back in the day, you used to trust your doctors and dentists to help you not siphon every dollar out of you.

 

[tcG]

Sucks that people get shafted into having metal amalgam or even composite fillings. Gold is bar-none, the best dental restorative material. Well-crafted gold inlays are fine works of art that will last your entire lifetime, don't stress adjacent teeth, mold perfectly to your bite, are chemically inert, and are readily accepted by the body.

 

[Schfifty Five]

I don't know how helpful this will be to you, but at my workplace, there's this kind of service that we can use to specifically help us in situations like this, where the dentist or dr told you one thing, but charged you for another.

Unfortunately I don't even know what the name of this type of service is but all I know is that they will fight those charges on your behalf.

I've never had to use this service, but some of my coworkers have and it's worked out for them.

Perhaps someone here knows what I'm talking about and can give better information than I can.

 

[DaveSimmons]

I think it's Hunan Resources. They can also help explain your French Benefits.



But seriously, talk to HR. It least where I've worked it's part of their job to sort out fights between insurance and doctors.

 

[Colt45]

I didn't know non-third-world countries even did amalgam except in catastrophe/war-rations situations... :awe:

 

[Jeff7]

I needed a chip in a tooth filled already, and at some point the dentist mentioned that one of the epoxies he's got on-hand isn't covered by insurance simply because it's white, versus the other that's slightly tan. Because the one is white, it's considered "cosmetic" by insurance, and therefore not covered, even though he also said that the actual materials cost of either one is very nearly the same, and that either one is just as effective as the other. I guess they try to get out of covering whatever they can reasonably expect to get away with.
And in any case, it's on a wisdom tooth; is it really cosmetic if no one can even see it?

 

[CPA]

This is why I always read the plan coverages, inside and out, on medical, dental and vision.

That said, you going in on half is probably as good of a deal as you're going to get. You should take it.

 

[rh71]

Had an insurance issue with my dentist as well - was so shady I had to write it all out on a letter to keep it straight. I gave it to the receptionist thinking the dentist wasn't privy to it but he defended her after seeing the letter. Came to the conclusion that they do everything they can to get money from your insurance because they know you're not paying for it - they are. I stopped going to them... I stopped going to any dentist, because of them.

My kid is going to a dermatologist and we had a co-pay issue. I asked specifically if there was a co-pay before leaving and they said no, both times. 3rd time they tell me now there's a late payment for not paying a co-payment. But only for the 2nd visit. They said I'm ultimately responsible but I'm wondering why when they're ultimately the ones collecting. Still expecting another late fee for the 1st time any day now. Makes no sense. I hate dealing with insurance issues.

 

[God Mode]

Every dentist I've been to since I could remember (6 yrs old) were total turds with inconsistent pricing, ridiculous upsells and overcharges all over the place. It's the medical equivalent of shady auto mechanics. Even the places recommended by friends end up giving me vastly different treatment and pricing than someone else. I guess being scum is what it takes to maintain their lifestyle.

 

[edro]

I trust 3M epoxy type fillings more than molten metal.

 

[Anubis]

I didn't know non-third-world countries even did amalgam except in catastrophe/war-rations situations... :awe:

i got one done 6 months ago. it wasent a matter of cost or my dentist being dumb, i have both types of fillings, but depending on where some are amalgam just holds up better

 

[SpatiallyAware]

Dentists are, imo, worse than chiropractors as far as additional crap you "have to have" which is "probably" covered by insurance. Generally their cost of materials is $15, they bill the insurance co $800 who denies it, then they do you a huge favor by settling for $400.

 

[ss284]

The majority of dental insurance plans either cover a small percentage of or less of the uber fillings you got.

Pay the $400. Fighting it is not worth your time.

 

[Tobolo]

Yeah, their screwing you over pretty good on that one. Although, you need to understand your own insurance before you go for these routing procedures. Emergency crown is one thing, but when you went back months later, you agreed to pay whatever the insurance didn't. During that down time you should have checked to see what was covered. Don't ever trust a doctors office.

 

[GrumpyMan]

Yup, have a dental plan with Metlife, went to get 1 root canal on a molar and prepped two other teeth for a titanium and porcelain bridge. Total cost $4000.00, insurance paid half. Now I have to wait till next year to do it over again on the other side and I'll be done. On the bright side the dental assistant was a Colombian bombshell with huge tits which she rubbed all over my face working on me. Nice.....tactic on the the dentist's part.

 

[Genx87]

Welcome to the world of insurance. The dentist office doesnt know you plan. They usually go off estimates of what most plans offer which in the dental industry is usually half the cost. They gave you an estimate.

They offering to meet you halfway is your best option. The other option is to be chased by a bill collector. Who will then go in front of a judge and you will need to explain why half the cost of the procedure is too much for your blood. The service was rendered and they are offering to cut the cost in half. I dont think there will be many judges out there who will give it to you for free.

 

[D1gger]

When getting anything substantial done, my dentist has always submitted a prior authorization request to my insurance company, who state exactly what amount they will cover, and send both my dentist and myself a copy of the statement. No confusion, and I have never received a bill that didn't match the before procedure estimate.

 

[SunnyD]

I think it's Hunan Resources. They can also help explain your French Benefits.



But seriously, talk to HR. It least where I've worked it's part of their job to sort out fights between insurance and doctors.

Yum, Hunan Resources. They make the BEST Hunan chicken!