dentist bill...WWYD?

[cepmom]

Back in Ocotber I received a reminder phone call from DD's dentist telling me that both DD's had appointments for cleanings later that week. I was surprised because it wasn't written on my calendar, but I figure I must have just forgotten to write it down...going to school, working and juggling the kids' schedules has totally fried my brain lol! Anyway, we go, DD10 gets cleaning, x-rays, flouride etc, DD13 gets her usual cleaning, flouride.

Now DD10 is covered for her dentist visits every 6 months under our HMO until she is 12, I pay for DD13, but the dentist just sends a bill the next month...no payment is required at the time of visit.

Last week I get a bill that shows DD13's visit as well as DD10's...insurance denied. I call the insurance and it turns out we were just there in June, so they will not pay for a visit within 6 months. Now I thought it was weird that we had an appt in October because I hadn't written it down, but I figured if they had it in their appt book, it must be correct. There's no way I would have requested an appt before 6 months had passed so I can't figure out why we were put in for only 4 months later

When I spoke with the billing manager, she checked the appt book and found both DD's scheduled for this upcoming January for cleanings as well, which would have been 6 months after their June appts. Somehow, someone at the office messed up and put my kids in for both October and January. Now insurance won't pay for DD10, but they still want me to pay the bill.

On one hand, they did provide a service and should be paid, but on the other hand, we wouldn't have gone to the appt in October if they hadn't made that mistake of putting them in 4 months after their previous cleaning.

I asked the manager if she could at least discount the bill somewhat and she is supposed to be talking with the Dr about it and get back to me.

Would you expect to pay the bill in full? Discounted? Or not at all?

 

[The Mystery Machine]

I would pay the bill because I would have checked to see prior to agreeing to coming in. I know that if it is before the 6mon period they are not going to pay.

I would consider this my error if I did not check up on my kids dental appts.

Now I know the office is the cause of this baloney but as the customer I put the burden on myself to know my own medical timelines.

Just chalk it up to lesson learned. Oh and double check everything from this office in the future. If you find more errors then I would certainly take action.

 

[cepmom]

yeah, I should have checked my calendar...totally my fault on that. I didn't check because my life is hectic and crazy but that's no one's fault but mine...I accept that!

I should have clarified in the OP...since I pay for DD13, the Dr waives the "periodic oral exam" fee of $40, but since he bills insurance for DD10, he charges the "periodic oral exam" fee, which he is passing on to me now since insurance won't pay for this. I am hoping he will waive it in this case. He did get paid for the x-rays though so at least that part got paid.

 

[mhsjax]

I would pay the bill because I would have checked to see prior to agreeing to coming in. I know that if it is before the 6mon period they are not going to pay.

I would consider this my error if I did not check up on my kids dental appts.

Now I know the office is the cause of this baloney but as the customer I put the burden on myself to know my own medical timelines.

Just chalk it up to lesson learned. Oh and double check everything from this office in the future. If you find more errors then I would certainly take action.

I disagree. I don't have record of appointments 6 months ago. Plus, from working in a Dr office, they have computer programs for this reason. They know that people don't keep up. When I do to my Dr, weather my gyn or dentist or whatever, I am told that I will be sent a reminder for that appt. In my opinion the dentist should at least discount this service. With 5 people in this house and appts running everywhere, I just don't keep those records.

 

[DisneyBamaFan]

It is not the responsibility of the dentist's office to ensure that your exams are paid for by your insurance company. That is yours, and it looks like you recognize that. Unless you had an agreement that all of these exams should only be scheduled when the insurance company would pay in full, this mistake is yours and yours alone. I would pay.

 

[mhsjax]

OP, maybe dentists offices are different, but as I stated earlier, Dr's offices are VERY aware of what insurance will and won't pay. When scheduling anything for myself or when I did it for a living for 13 years. We would always double check the last appt. Most insurance will only pay for things within a specific timeline and when we scheduled and also whne I am being scheduled, my Dr's office will always check to make sure that the appt is within the allowed time line.

It has also been my experience that with Dentists and HMO's, they will try and milk as much money out of them and the patient as possible. I had an MHO and went to a different Dentist, I was told a whole list of things that needed to be taken care of. All of them required different co pay amounts. Wen to 2 other at 6 month intervals, neither of them on an insurance plan. Both agreed that my teeth were literally perfect and needed nothing but routine cleaning. So I guess I am jaded for these reasons. All that being said I would pay if they didn't offer a discount, but I sure would be asking for one.

One other note, routine dental cleaning is 6 months, the dentist office does know this and really in the end it is the responsibility of the patient, but there is no way that the dentist office doesn't know this rule. It is like asking an 8th grader what 2+2 is. They had no reason to schedule this patient earlier than 6 months, weather or not the op pays for this (and yes I would but they would hear about it) it was a mistake made my the dentist's office.

 

[Mickeypooh99]

We don't have dental insurance. I don't worry if I schedule an appointment before 6 months, because we pay out of pocket either way. But my dentist will call us and question it if it is before 6 months. They want to warn me that my insurance wont pay for a visit sooner than 6 months. I always have to explain to them that we don't have insurance.

My point is, they should know if it is before 6 months. They should have questioned it. I think they should at least give you a discount on the bill. They did make a mistake by scheduling that appointment.

 

[BriarfoxinWA]

yeah, I should have checked my calendar...totally my fault on that. I didn't check because my life is hectic and crazy but that's no one's fault but mine...I accept that!

I should have clarified in the OP...since I pay for DD13, the Dr waives the "periodic oral exam" fee of $40, but since he bills insurance for DD10, he charges the "periodic oral exam" fee, which he is passing on to me now since insurance won't pay for this. I am hoping he will waive it in this case. He did get paid for the x-rays though so at least that part got paid.

I would try to get them to waive that fee as well. But as for the rest of it, I'd pay it and be more careful in the future.

 

[mhsjax]

We don't have dental insurance. I don't worry if I schedule an appointment before 6 months, because we pay out of pocket either way. But my dentist will call us and question it if it is before 6 months. They want to warn me that my insurance wont pay for a visit sooner than 6 months. I always have to explain to them that we don't have insurance.

My point is, they should know if it is before 6 months. They should have questioned it. I think they should at least give you a discount on the bill. They did make a mistake by scheduling that appointment.

Exactly.

 

[cepmom]

It is not the responsibility of the dentist's office to ensure that your exams are paid for by your insurance company. That is yours, and it looks like you recognize that. Unless you had an agreement that all of these exams should only be scheduled when the insurance company would pay in full, this mistake is yours and yours alone. I would pay.

I respectfully disagree that this problem is mine alone. Yes, I should have known the October appt was less than 6 months, but they never should have put DD's in for October in the first place. In fact, we did have an appt scheduled for 6 months later...how the Ocotber appt got put in I have no idea. When they called to say we had an appt that week (in October) I should have checked my records better. That is my fault. I say the blame lies on both sides

 

[DisneyBamaFan]

I respectfully disagree that this problem is mine alone. Yes, I should have known the October appt was less than 6 months, but they never should have put DD's in for October in the first place. In fact, we did have an appt scheduled for 6 months later...how the Ocotber appt got put in I have no idea. When they called to say we had an appt that week (in October) I should have checked my records better. That is my fault. I say the blame lies on both sides

I know you do, and many will agree with you. I am just too much of a "personal responsibility" type to agree. You asked for opinions. I understand that you disagree.

 

[WDWisTheBest]

I respectfully disagree that this problem is mine alone. Yes, I should have known the October appt was less than 6 months, but they never should have put DD's in for October in the first place. In fact, we did have an appt scheduled for 6 months later...how the Ocotber appt got put in I have no idea. When they called to say we had an appt that week (in October) I should have checked my records better. That is my fault. I say the blame lies on both sides

While I agree that it was unfortunate that the October appointment was scheduled, maybe it would be best to pay the bill for services received. In the future the insurance situation will dictate appointments, won't it?

 

[mjkacmom]

I have 3 kids on a 6 month schedule, 2 other kids on another 6 month schedule, DH and I are on different 6 months schedules. We make the appointment at our visit, get a postcard in the mail a few weeks before the appointment, and an email the day before. If I got a call a week before, telling me I had an appointment, and it was ony 4 months later, I'd have no idea that it was too soon. They don't write it down for me when I make the appointment - I count on that postcard. They never make appointments within the 6 month window, because they know insurance will not cover it. I think the office is, at the very least, partially responsible for the error.

 

[mjkacmom]

While I agree that it was unfortunate that the October appointment was scheduled, maybe it would be best to pay the bill for services received. In the future the insurance situation will dictate appointments, won't it?

But the insurance always dictates the appointments. I can't even make an appointment for any medical checkups with any of our providers inside the given window. When I call to schedule appointments, they always look up when I've been there last, to make sure it is covered by insurance.

 

[cepmom]

While I agree that it was unfortunate that the October appointment was scheduled, maybe it would be best to pay the bill for services received. In the future the insurance situation will dictate appointments, won't it?

Insurance has always dictated the timimg of appts...that's why we had one scheduled in January 2011. We will pay the bill; I would like to think the Dr would waive the oral exam fee though since he never charges that for those that don't have insurance coverage. It's only $115 for the cleaning and flouride (x-rays were covered), so not a huge deal. Just annoying.

 

[Pakey]

Insurance does not dictate my appointments; I do. If you received the service, you pay for it.

 

[cepmom]

Insurance does not dictate my appointments; I do. If you received the service, you pay for it.

I didn't make the October appt; I made the January appt when I knew my ins would pay for it

 

[DisneyBamaFan]

I didn't make the October appt; I made the January appt when I knew my ins would pay for it

This is the part that confuses me - I would never miss something like that. I put my appointments on my calendar at home and at work. If I got a card reminding me about an appointment not on my calendar, I would call to ask about it, I wouldn't just show up.

 

[cepmom]

This is the part that confuses me - I would never miss something like that. I put my appointments on my calendar at home and at work. If I got a card reminding me about an appointment not on my calendar, I would call to ask about it, I wouldn't just show up.

in the past I would have never missed something like that either, but I started back to school this year (after 15 years!),was working 2 jobs at that time and was juggling my kids' schedules while DH's was away on business.

My life was way more hectic than I care to deal with and I didn't double check. Honestly, I didn't remember that we had "just" been there in June or that I had made my appt for January (while I was standing in the office back in June)...half the time I can't remember what happened last week never mind 4 months prior.

I thought it was weird that it wasn't on my calendar but figured with all my life's craziness, that I must have just forgot to enter it in.

I don't have a whole year calendar hanging up in the kitchen that I could have flipped a pge to check back, I use a program installed on my old computer, so it would have entailed my turning it on, and waiting for it to open (very old computer lol...very slow to load) and research it further, but I didn't. My fault...not blaming anyone for that. you can be sure I'll double check all appts from now on though!

 

[DisneyBamaFan]

If you are a long standing customer, they will probably work with you. Dentists make a fortune treating children. They can afford to take a little hit to keep a good patient.

Good luck.