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My daughter have 6 cavity fillings done at the dental office last December. They sent us a bill to charge for $194/teeth, but my insurance (Atena DMO) said they should charge significantly less since they are in the DMO network. I told the dentist's office about this, but they insist to charge this much because they did the same on my wife's filling. For my wife's filling, I did not check my insurance so we paid the charge in full. After I got my daughter's bill, I tried to call them to argue that, and even asked my insurance to talk to them directly not to charge this much because of the DMO network, but the dentist did not listen. My insurance company said they will use their company resources (probably a negotiator or coordinator) to persuade the dentist, but I have not heard back from them. Today I received the bill from the dentist again, what should I do? Continue to ignore it? What if it go to collection company? What are the negative consequences I should face?
I am planning to give my insurance company (Aetna DMO) a call to follow up this, but I am afraid they may not continue to help me to fight the bill because this year I am using another dental insurance.
When I had dental insurance they rarely covered the full cost of any procedure. That is standard procedure for every insurance company I've ever had dental insurance with. Many plans have a yearly limit of about $2,000 and once you reach it they will not cover any more services for that calendar year. IMO dental insurance is not worth the paper its printed on! Pay the bill; make arrangements for a payment plan or be prepared for the dentist to send that bill to a collection agency, who will then report it to a credit reporting agency.
You're responsible for the part of the bill that your insurance doesn't cover.
It's up to you, the insurance holder, to know just what and how much your insurance will cover. Getting a written estimate ahead of time and confirming exact coverage is always a good idea. My dentist's office manger hates that I do this, but I don't care....I want maximum benefit from the ins I pay for.
If you choose to not pay this bill, it will effect your credit sooner or later, and you'll need to find a new dentist.
My daughter have 6 cavity fillings done at the dental office last December. They sent us a bill to charge for $194/teeth, but my insurance (Atena DMO) said they should charge significantly less since they are in the DMO network. I told the dentist's office about this, but they insist to charge this much because they did the same on my wife's filling. For my wife's filling, I did not check my insurance so we paid the charge in full. After I got my daughter's bill, I tried to call them to argue that, and even asked my insurance to talk to them directly not to charge this much because of the DMO network, but the dentist did not listen. My insurance company said they will use their company resources (probably a negotiator or coordinator) to persuade the dentist, but I have not heard back from them. Today I received the bill from the dentist again, what should I do? Continue to ignore it? What if it go to collection company? What are the negative consequences I should face?
I am planning to give my insurance company (Aetna DMO) a call to follow up this, but I am afraid they may not continue to help me to fight the bill because this year I am using another dental insurance.
Thanks
You won't know whether or not they'll continue to fight the bill, if you don't contact them. It's going into the third month since your daughter had the treatment, and the dentist still hasn't been paid yet. It's your responsibility to make sure that bill gets paid, regardless of who is writing out the check.
So get in touch with the insurance company and follow up.
Ah, the joys of paying for dental work. I haven't had dental insurance for many years, and so far it hasn't come back to bite me. But that's because I take the creative approach: dentist hopping. Every time I need to see the dentist, I go on Groupon or do a web search looking for a new search for a dentist who will give me a discounted rate on a new patient exam, cleaning, and x-rays. I go to the dentist, get those procedures done, and hope that I don't need any expensive dental work done. So far I've gotten lucky and avoided it. And every time I asked them about getting a discount as a cash pay return patient, they won't give me one, so the return visit would end up costing about 5 times as much. Then I am faced with no other alternative but to get another dentist six months later.
What an insane system we have for dental health. I don't understand why our healthcare system doesn't consider our teeth part of our bodies; a system that needs care and maintenance just like the rest of it. And I don't understand why dentists don't care about return patients or patient loyalty. They want new patients, then after that, all bets are off. Dental insurance would end up costing me more than getting Groupons, so I continue doing this. I've been to five different dentists in the past three years
What an insane system we have for dental health. I don't understand why our healthcare system doesn't consider our teeth part of our bodies; a system that needs care and maintenance just like the rest of it.
Because teeth are not a medical necessity. You can eat and drink and breathe just fine without them. That's the function of your mouth: to eat, drink, and breathe. There's no such thing as "SSI disability payments because you have no teeth."
Medical insurance covers medical issues. If your jaw was deformed, or broken, then THAT would be a medical issue. If a tooth was growing backward into your sinus cavity and it needed to be extracted and the sinus repaired, then THAT would be a medical issue. Dental issues just aren't medical. It's unfortunate, but it's just how it is.
Because teeth are not a medical necessity. You can eat and drink and breathe just fine without them. That's the function of your mouth: to eat, drink, and breathe. There's no such thing as "SSI disability payments because you have no teeth."
Medical insurance covers medical issues. If your jaw was deformed, or broken, then THAT would be a medical issue. If a tooth was growing backward into your sinus cavity and it needed to be extracted and the sinus repaired, then THAT would be a medical issue. Dental issues just aren't medical. It's unfortunate, but it's just how it is.
I disagree. Dental issues can turn into medical issues. For example, gum disease and heart disease.
Heart disease is only linked to dental problems in that an infected tooth, untreated, left to fester, can infect the bloodstream, and lead to heart disease. You can't get heart disease as a result of an infected tooth, if you have no teeth. Again - DENTAL issues are not medical. Medical issues are medical. Once a dental issue becomes a medical issue, it's no longer a dental issue. Dental issues involve teeth. No teeth = no dental issues.
I think the point is that everybody WANTS teeth but nobody NEEDS teeth. We have 400 pound people walking around without any teeth in their mouth. They're sure getting nutrition somehow. Teeth are not for everyone. They are a luxury to some and a liability to others.
Ah, the joys of paying for dental work. I haven't had dental insurance for many years, and so far it hasn't come back to bite me. But that's because I take the creative approach: dentist hopping. Every time I need to see the dentist, I go on Groupon or do a web search looking for a new search for a dentist who will give me a discounted rate on a new patient exam, cleaning, and x-rays. I go to the dentist, get those procedures done, and hope that I don't need any expensive dental work done. So far I've gotten lucky and avoided it. And every time I asked them about getting a discount as a cash pay return patient, they won't give me one, so the return visit would end up costing about 5 times as much. Then I am faced with no other alternative but to get another dentist six months later.
What an insane system we have for dental health. I don't understand why our healthcare system doesn't consider our teeth part of our bodies; a system that needs care and maintenance just like the rest of it. And I don't understand why dentists don't care about return patients or patient loyalty. They want new patients, then after that, all bets are off. Dental insurance would end up costing me more than getting Groupons, so I continue doing this. I've been to five different dentists in the past three years
Do you complain about paying for groceries, auto repair, mortgages in this manner as well?
No other alternative, haha. The alternative is to actually spend your own money on your teeth instead of relying on someone else to give it to you for free.
You talk about patient loyalty yet you make it clear that you only care about free/cheap dental work. If your doctor doesn't do that, then you are out. How is that loyalty?
There is a saying among dentists that "a patient's loyalty is as thin as their credit or insurance card". You are the prime example of this.
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