Reply
Honored Contributor
Posts: 17,892
Registered: ‎07-03-2013

Re: Dental Insurance/Bill question

Pay the $91.

Honored Contributor
Posts: 35,605
Registered: ‎05-22-2016

Re: Dental Insurance/Bill question

[ Edited ]

Ask for a discount, pay it and leave it at that.

 

I always ask for a discount whenever I have to pay a bill. It never hurts to ask.

Valued Contributor
Posts: 887
Registered: ‎03-03-2016

Re: Dental Insurance/Bill question

it's the patients responsibility to be aware of the terms of their insurance plan, not the dental office.  Contrary to some of the information on this post, some plans will pay for two cleanings a year, they do not have to be six months apart. Delta Dental is one of those plans and their are others.

 

The office is only obligated to provide the standard of care to their patients, billing insurance is a courtesy.  

 

Pay them immediately.

Frequent Contributor
Posts: 138
Registered: ‎08-07-2018

Re: Dental Insurance/Bill question

@Puppy Lips... I'm a dental practice manager.  Here's what I can tell you- you do owe your office for his visit.  Most dental offices (mine included) will tell you that any services not covered by your insurance will be your responsibility to pay.  I'm sure I speak for a lot of dental offices also when I say this- your insurance is essentially an agreement between you, the insurance company and your employer.  We file claims as a courtesy to our patients, but we're not directly affiliated with  insurance companies.  We do our very best to get all benefit information ahead of time for our patients, but ultimately it is the patient's responsibility to know and understand their benefits.  Most offices will spell this out in their office/financial policy paperwork.  In my office, our patients sign and date this agreement. There are literally hundreds of different plans with different benefits out there, and these benefits can and do change regularly.  Some cover cleanings twice a year anytime, some are six months to the day, no sooner.  And $91 isn't a bad deal for a regular adult cleaning.  I'd chalk this up to a learning lesson, and next time I'd be sure to double check on eligibilty before going in for your cleaning appointments, just to be safe.

Valued Contributor
Posts: 887
Registered: ‎03-03-2016

Re: Dental Insurance/Bill question

[ Edited ]

I just reread your post, so the claim has been denied three times.  The dentist provided a service and has waited all this time to be,paid?  Not fair.  It’s your responsibility, pay it, I would have charged you interest.

 

i am appalled by this, do you wait weeks or months for your paycheck?  Do you realize tha the dental hygienist was paid promptly by the doctor, yet you have not paid him?  

 

Pay at the bill and do not ask for a discount.  I’d be embarrassed if I were you.  Tacky

Honored Contributor
Posts: 35,605
Registered: ‎05-22-2016

Re: Dental Insurance/Bill question


@StephaniM wrote:

I just reread your post, so the claim has been denied three times.  The dentist provided a service and has waited all this time to be,paid?  Not fair.  It’s your responsibility, pay it.  I’m appalled by this,  do you wait several weeks or months to be paid for work you’ve done?  And don’t ask for a discount.  Tacky


 

 

Why is asking for a discount tacky? I've saved hundreds of dollars by asking for a discount if I paid with cash.

Valued Contributor
Posts: 887
Registered: ‎03-03-2016

Re: Dental Insurance/Bill question

[ Edited ]

In this case, it’s tacky because she has had. The nerve to not pay her bill because she wasn’t aware and then didn’t agree with her insurance limitations.  Her doc provided a service and should not have to carry a balance for weeks or months on the account because of it.

 

 

Honored Contributor
Posts: 17,491
Registered: ‎03-10-2010

Re: Dental Insurance/Bill question

All of the medical practices I go to track the insurance limits for me (well woman, dental cleanings/xray timelines, etc.)

 

My company changed our xray timeline a couple of years ago and my dentist does not go back and review insurance changes each year, but they didn't make me pay for the xrays.  I do bring the dental summary with me now so that we don't have that problem again.

===================================
QVC Shopper - 1993

# IAMTEAMWEN
Honored Contributor
Posts: 11,775
Registered: ‎03-11-2010

Re: Dental Insurance/Bill question

So what did you do?

When I lose the TV controller, it's always in some remote destination.
Respected Contributor
Posts: 4,106
Registered: ‎03-28-2010

Re: Dental Insurance/Bill question


@Puppy Lips wrote:

Asking for your opinions here.  My son came home from college for the summer and was about to start a summer internship.  I called the dentist's office to get him in for his 6 month cleaning.  He went on June 15.  However, Cigna Dental denied the claim because it was 3 DAYS shy of his 6 month time frame.  His last cleaning was on Dec. 18.  I called the dentist's office and the woman said that if I request it, Cigna dental will cover it.  Well I appealed twice more and was denied.  I wrote letters and even had a conference call with 3 women.  After I got the 3rd denial, I got mad and cancelled the insurance.  You can bet I will follow up with letters to vent my frustrations to them.

 

In the meantime, the dentist's office is asking I pay the $91.00 balance.  I know that is not a lot.  But, I feel that they should have never offered my son this appointment since it was before the 6 months were up.  At the time however, that was all they had until my son was already back at college.  They did not tell me it was before the 6 months, and frankly if they had, I would not have thought twice about it.  But they deal with insurance everyday and know the rules.

 

Do you think I should pay the $91 in full, suggest maybe we split it, or put all the blame on them?  I think they have some responsibility here.


I can see two sides of the coin here.  On the one hand, it's only a 3 day difference.  IMO not such a big deal.  Should the insurance company do the right thing and say the same thing and cover it?  Sure.  But in reality they won't.  Unfortunately, it's the policy holders responsibility to know the in's and out's of what is covered and when.  My dentist (and doctors) have you sign a paper about billing, that it's up to the patient to know about coverage and bottom line is that the patient is responsible for payment.