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Old 06-05-2010, 05:26 PM
 
734 posts, read 1,772,879 times
Reputation: 535
Default Broken tooth after unfinished root canal-pay in full?

Hi,

My husband had part of a root canal done, and after a few weeks the tooth broke and my husband had to have the tooth pulled.

At the time it broke, my husband had a dentist appointment scheduled for that week, which he thought was to complete the root canal, however, it was just for a cleaning, so it does not seem like the dentist or my husband were paying much attention to the root canal situation (sigh!).

Anyway, the insurance company paid their portion of the root canal in full, which resulted in my husband reaching his yearly insurance mximum. So, technically we are responible for the full cost of the tooth extraction, and for the cleaning (and full x-rays, which I am not sure why they took when my husband reached his insurance maximum!).

If the insurance company only pays for half of the root canal, then there would be enough for them to pay for my husband's tooth extraction, cleaing, and x-rays.

Does anybody know what is typically done in situations like this? Do you think the dentist should and will return half of the root canal payment to the insurance company? Would it be fraudulent for the dentist to leave the root canal insurance payment as is, and then consider our balance with the dentist as paid?

Just trying to determine our rights before I try to work with our dentist, who has been my dentist for 10 years. Also, the bills are in my name since the insurance is in my name.

Thanks!
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Old 06-05-2010, 05:34 PM
 
Location: Fort Wayne
470 posts, read 577,118 times
Reputation: 259
Quote:
Originally Posted by Reneeme View Post
Hi,

My husband had part of a root canal done, and after a few weeks the tooth broke and my husband had to have the tooth pulled.

At the time it broke, my husband had a dentist appointment scheduled for that week, which he thought was to complete the root canal, however, it was just for a cleaning, so it does not seem like the dentist or my husband were paying much attention to the root canal situation (sigh!).

Anyway, the insurance company paid their portion of the root canal in full, which resulted in my husband reaching his yearly insurance mximum. So, technically we are responible for the full cost of the tooth extraction, and for the cleaning (and full x-rays, which I am not sure why they took when my husband reached his insurance maximum!).

If the insurance company only pays for half of the root canal, then there would be enough for them to pay for my husband's tooth extraction, cleaing, and x-rays.

Does anybody know what is typically done in situations like this? Do you think the dentist should and will return half of the root canal payment to the insurance company? Would it be fraudulent for the dentist to leave the root canal insurance payment as is, and then consider our balance with the dentist as paid?

Just trying to determine our rights before I try to work with our dentist, who has been my dentist for 10 years. Also, the bills are in my name since the insurance is in my name.

Thanks!
Ummm..why the dentist wait so long to fix the root canal's completion?
And won't the dentist work w/ you on the bill,OP?
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Old 06-05-2010, 06:03 PM
 
734 posts, read 1,772,879 times
Reputation: 535
Quote:
Originally Posted by cocytus View Post
Ummm..why the dentist wait so long to fix the root canal's completion?
And won't the dentist work w/ you on the bill,OP?
I don't know why the dentist waited so long. My husband expected the root canal to be finished that week at the time of his cleaning, however, my husband said that the dentist seemed surprised that the root canal was not finished, so it seems like the dentist forgot. I am more of a pro-active patient than my husband, so it's hard to picture how it happened.

I have not talked to the dentist yet. He is great teeth-wise (usually!), however, I am not sure he will be easy to deal with money wise (a friend of mine had a bad experience with him once), so I was trying to see what I could/should expect before I called him.
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