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Old 09-04-2014, 04:46 PM
2 posts, read 3,059 times
Reputation: 10


So I have had a dental plan with my university since last year and I got three cleanings in a year. I never have to pay for the service because it's always covered. (Except one time that I had to pay for another service out of my pocket because it wasn't covered and they let me know before I got the thing done, so I just paid it right away on the same day)

However, I just got a bill saying that I have to pay for the last cleaning so I called the office and asked them about it. They said my plan only covers 2 cleaning per year and then I checked and it really does.
When I scheduled an appointment, they didn't say anything about me having to pay so I just went into the office without knowing. The last time that I went to the office for this cleaning, they didn't tell me a bit that I have to pay because it's the third cleaning. So I ended up walking out of the office thinking that everything was fine until I received the bill...$70

I mean, even though it's clearly not covered, isn't it also their job to let the customer know that they have to pay first though? It seems like they just want me to come in multiple times in a year for the cleaning and not even letting me know about paying and being shady to the customer.

Anyway, I kinda know I'll have to pay anyway as long as I still want to go in and receive the dental services from them because I still have the school health plan (which I pay almost $600 per quarter.. yuck!)

What's your opinion regarding this.
(This is my good lesson. Now I know I have to pay a much more careful attention and try asking them every time before I go in if there's any kind of services that I will be billed for)
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Old 09-04-2014, 05:01 PM
595 posts, read 2,400,965 times
Reputation: 1214
Short answer, no, it's not their job to know what you qualify for. Dental offices file claims for insurance benefits ON BEHALF of the patient as a courtesy for the most part. It's on you as the patient to know and understand what your insurance plan covers.
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Old 09-04-2014, 06:30 PM
Location: Dallas TX
15,555 posts, read 22,915,265 times
Reputation: 23787
Definitely not their job. At least it was a cheap lesson.
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Old 09-04-2014, 10:12 PM
1,552 posts, read 1,939,048 times
Reputation: 2379
This is YOUR insurance and not the dentist's insurance. You are responsible for knowing what you signed up for. There are hundreds of plans out there and the dentist has no way of knowing the details of each and every plan and has no obligation to figure it out for you. Many offices will help you figure this out as a courtesy, but they are definitely not required to. I agree this was a cheap lesson.
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Old 09-05-2014, 02:47 PM
Location: Santa Monica, CA
1,626 posts, read 3,420,971 times
Reputation: 734
Just go every 6 months for a cleaning. Every 4 months is excessive if you have relatively healthy teeth. Hell, I know people who struggle to make it to the dentist every 2 years.

You'll be in for a real surprise with dental insurance if you ever need more expensive work like restorations done. It's surprising how little most dental plans when it comes to stuff like that. Mine covered like ~40% when I had a bunch of fillings placed several years back. Even if you think your plan covers something after reading the terms of service they can always deny a charge after the fact. I'll tell you though, vision coverage is even worse....
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