dentist bill...WWYD?

[NewCrew42]

I just went thru something similar at our dentist office.

DS15 had his wisdom teeth removed in October.

He had an appointment for cleaning the first week of November. We changed the cleaning appointment, as the November appointment was too soon after his surgery date and his mouth needed time to heal. Their next available appointment was Dec. 21st.

In the meantime, we have a followup for the wisdom teeth removal at the oral surgeon's office. At the end of the visit, I am going over the final financial obligations with the oral surgeon's business office. They tell me we have used all of our dental insurance funds for the year 2010. We have maxed out and that if we have any other dental apppointments we might want to reschedule them for 2011, unless of course it is an emergency.

So, I call the dental office, to reschedule our Dec. 21st cleaning for January and I explain the situation to them. No problem, we have an appointment for Jan. 10.

Then I get a call last week as a reminder for our Dec. 21st cleaning. I let them know we cancelled, due to insurance. Well, the office argues with me that we have only had one cleaning in 2010 and DS's insurance should pay for two. That we NEED to come in and get his teeth cleaned to use our maximum benefits for 2010. I once again explain to her that we are NOT coming in, Dec. 21st as insurance will not pay and we have used ALL of our benifits due to the wisdom teeth extraction. Then she tells me that I am wrong and that the wisdom teeth extraction was covered under our major medical and that our dental insurance cleaning benefits are still available.

Well, I know this to be very WRONG, so I say, let's both call the dental insurance company and see what they say. Because I KNOW that the wisdom teeth extraction was NOT covered under major medical and that we maxed out our dental insurance and that I had to pay nearly $900 out of pocket in addition to the dental insurance for the extraction.

So, we hang up. About 10 minutes later she calls to tell me that I am right, we have maxed out our dental insurance for 2010 and that in order to receive insurance benefits, it would be best to wait until Jan. for DS to have his teeth cleaned.

Long story short, know your own benefits. OP, I would be in the same position as you, except that the oral surgeon's business office had informed me of using all of my benefits.



I also see a trend that they are pushing for younger kids get their teeth cleaned every 4 months. They are pushing this at my dentist office currently.

 

[ajk912]

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 really hate when practices take this mentality. I pay a hefty price for my insurance for a reason, if a practice isn't familiar with that insurance I will find another practice who is familiar with my insurance. I would have to REALLY REALLY like a practice who takes a "we bill your insurance as a courtesy, it's your responsibility" standpoint. That's a good way of chasing away clients. I prefer to deal with the "we will work with your insurance and find a way to get paid" practices. I even had a doctor write off a charge they tried to bill me because they failed to get the proper preapproval with the insurance company. I am not in the insurance or medical business, I feel that my responsibility ends with my coinsurance or copay- if you (the practice) don't believe you will get the remainder from the insurance, it is best that you let me know before we are seen so that YOU (the practice) receive full payment. THOSE are the practices we frequent. Usually those practices are larger and have someone who specializes in insurance (one even had on the message, if you use blank X or Y as your insurance, press 2) etc, now that's efficient.

 

[clutter]

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 had a similar thing happen. In my case, my dd goes to the dentist every month for braces. One month, I had a sitter take her, and they did a cleaning. Well, I knew it wasn't time for a cleaning and that the insurance wouldn't pay. They did waive the charges. But in my case, I remembered when the last one had been, and I had them check their records. There was no way I'd have scheduled a cleaning with the brace adjustment, so if I'd been there, I would have stopped them.

In your case, I agree that the appointment is suspect. How would it have gotten scheduled? But, I probably would have had them check the records for the last cleaning to check before going. (Just because it is a royal pain to get off of work for the dental appts, so I always make sure dd NEEDS to go, lol.)

 

[kirstenb1]

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.

This is the way our doctors and dentist operate too. The appt is always "after__date", meaning a year or six months after the last appt. I think the OP is not being unreasonable in asking the dentist to share the cost of the error.

 

[horseshowmom]

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

OP, I understand where you're coming from. I normally do put our dentist appts. on the calendar but have been known to get busy and forget to do it. Our dentist always calls two or three days ahead of time to remind us. I know that is what is going to happen - otherwise I would make SURE to put it on the calendar every time.

If my dentist called like yours did, I would have gone on in unless I was positive that they had the time wrong (because I know how fast time slips away). In this case, I would approach it from the angle that "we have a problem, I came in because your office called and told me it was time for my appt. - an appt. that I clearly did not make." I think both parties were equally at fault, and the dentist's personnel should share the blame. It's very possible that they don't want him/her to know that they made this mistake so you may need to ask to speak to the dentist yourself.

If they worked with me, fine. If they didn't, I would pay them (recognizing that I should have kept up with it and not depended on them), but I would change dentists (because I don't need a dentist whose office operates this way - and I would tell them that).

 

[DisneyBamaFan]

FWIW, I just asked my wife. She said that she "would not pay that bill without some relief".

Seems she agrees with the posters suggesting that the dentist has some culpability.

 

[Rora]

Honestly, I'd just pay in full and be extra careful next time. Sorry for what happened though. It's certainly rude of the dentist..

 

[Lisa loves Pooh]

Tough one.

I'd say what is done is done and just pay and in the future--doublecheck to make sure.

Our insurance is 6 months plus 1 day, so I try to stay on top of it.

October is 5 months--and it just looks like they weren't fully thing. (was it something like 5 months and a couple of weeks?)

It was close enough--so I'd just learn from it and pay it.

It isn't like they had you come back 2 or 3 months early.

And since you have to pay cash, It wouldn't hurt to ask for a small discount.

But with insurance, it is ALWAYS the insured's responsibility to follow the rules. I'm not sure the dentist was intentionally trying to make you pay all cash.

 

[cepmom]

Tough one.

I'd say what is done is done and just pay and in the future--doublecheck to make sure.

Our insurance is 6 months plus 1 day, so I try to stay on top of it.

October is 5 months--and it just looks like they weren't fully thing. (was it something like 5 months and a couple of weeks?)

It was close enough--so I'd just learn from it and pay it.

It isn't like they had you come back 2 or 3 months early.

And since you have to pay cash, It wouldn't hurt to ask for a small discount.

But with insurance, it is ALWAYS the insured's responsibility to follow the rules. I'm not sure the dentist was intentionally trying to make you pay all cash.

it was just under 4 months...they went in on June 29 and went again on October 24 so it wasn't like they made the appt a couple weeks early or something. I have no explanation on why an appt was made on 10/24 when they also had one made for January 2011 it's a mystery we'll probably never know why or how the October appt was made.

I totally don't think this was done intentionally...it was just a mistake that we both bear responsibility for (IMHO!)I'm still waiting to hear back from the billing manager (we spoke last week) I did tell her I understand they need to be paid for their service but was hoping for some sort of courtesy discount. DH has been a patient there since he was a little kid and the girls have been going there for several years. I'd be surprised it they didn't at least waive the oral exam fee but we'll see

 

[surfergirl602]

We have a great dentist, and I really like him. He is great with the kids. His receptionist, on the other hand, leaves much to be desired. She can never get anything right, it seems. She sends me bills for things that insurance should take care of, and I end up calling them to get it straightened out, when that is her job to bill them.

My girls also had to have a baby tooth pulled because the adult tooth grew in behind it, and the baby tooth never loosened. Our dentist sent my kids to the pediatric dentist because they had a better way of pulling the tooth or something - laugh gas or something? Well, they did a cleaning while they were there - they did not ask me about it, they weren't scheduled for it, and I didn't even know they did it. The parents cannot go in during procedures there.... my insurance was billed. So... the next month when I took them to their regularly scheduled cleanings at our normal dentist, it came back that the insurance wouldn't pay for it, and I had to pay for it out of pocket. I was FURIOUS!!! It took forever to clear up, and I will never take my kids back to the ped. dentist again. Shady practices.

Oh, and get this - this is how they did the "cleaning". Put on a pink dye, and brushed their teeth with a toothbrush until all the pink was gone. Seriously?!?!?

 

[Lisa loves Pooh]

it was just under 4 months...they went in on June 29 and went again on October 24 so it wasn't like they made the appt a couple weeks early or something. I have no explanation on why an appt was made on 10/24 when they also had one made for January 2011 it's a mystery we'll probably never know why or how the October appt was made.

I totally don't think this was done intentionally...it was just a mistake that we both bear responsibility for (IMHO!)I'm still waiting to hear back from the billing manager (we spoke last week) I did tell her I understand they need to be paid for their service but was hoping for some sort of courtesy discount. DH has been a patient there since he was a little kid and the girls have been going there for several years. I'd be surprised it they didn't at least waive the oral exam fee but we'll see

I missed the June date--I was giving BOD that it was earlier June.

 

[cm8]

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?

That happened to me at my Dentist I had for a really long time. They then tried to turn it around on me and even sent me a letter acknowledging their fault, but basically said that I needed to "eat" the cost since I should have "reminded" them to do their job correctly I paid the $124.00 and NEVER went back.

Now when they call to "schedule" me I tell them no thanks. I found another dentist and told them upfront what my issue was and if it happened here, I would not hesitate to find another dentist. Hasn't happened since. The other Dentist does keep calling me asking when I'm ready to come back. I told her when she is willing to eat the cost of their mistake I will return. She hasn't so I haven't,. Have not looked back since. I still don't understand why they keep calling me though

If you feel jilted, write a letter to the Dentist and have it addressed, but I would expect to pay in full. If she/he wants your business, they should eat the cost and move on.

 

[ols386]

If I were in your position (op) I would go ahead and pay the dentist the amount owed to them. Yes, they did make a scheduling error, but it's MY responsibility to know how and when my insurance pays, or when it does not pay.