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And trying to sell people services by falsely telling them that they confirmed with insurance that it is covered is fraud and deception.
It is people who stand up for shady businesses that rip consumers off that are part of the problem.
In addition, verifying coverage for an average person is very difficult, the process is a maze of billing and procedure codes known only to the doctor and provider. I have tried to do this before and gotten nowhere, I was asked for a procedure code, subcode, billing code (different from procedure code) and even then the representative told me that they could not tell me if it was covered or not until the claim was submitted. We need more regulation to hold these insurance companies accountable. Too many of these companies are ripping people off with impunity.
The dentist should not have assured me that insurance is going to pay but rather said it may or may not be covered by insurance and they can only submit a claim. I have had doctors tell me that before and that is the honest thing to do. In this case as I said the dentist swore that the agent said it was 100% covered without any issue despite me telling the dentist that I wasn't sure. That is why I am pissed off, it is a deliberate attempt to deceive in my opinion.
I understand why you are angry, but it sounds like you should be directing some of that anger at the insurance agent who told the dentist the procedure was covered. How come you're not blaming the insurance company? The dentist doesn't work for the insurance company. Also, in your previous post you said it was 90%, now you are saying 100%. Which is it?
Do you have a signed treatment plan and financial agreement?
This is not true. Just because you send them a check for $5 does not mean they have to accept it. You can't go to McDonalds, order $5.78 worth of food, eat said food, then send them a quarter every week as payment. Even the 16 year old kid working the cash register knows to take the money up front in full before giving you your food. Don't like those terms? Fine, next in line please.
This is not a bias, it is just common sense.
If McDonald's says my bill will be $5 at ordering and wants $15 after they give it to me, they are not going to get it.
Common sense.
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If the dentist was truly dishonest - your coverage was never checked - I would say he is shady.
Your insurance said it was considered not medially necessary once the claim was processed. I would try that angle too - check with the payer asking what exactly is the problem then ask the provider to appeal it. Meanwhile, pay the dentist to avoid collections.
The procedure probably is covered - IF you need it and/or the dentist provided proof of that beforehand or after if indeed it was necessary. Covered is not the same as approved.
If McDonald's says my bill will be $5 at ordering and wants $15 after they give it to me, they are not going to get it.
Common sense.
Absolutely. They give you the total fee prior to your purchase decision, and it's up to you if you accept those terms or not. Also, there is no 3rd-party paying part of your burger. It is just you. A dentist does the same thing, but since someone else other than you is sometimes paying part of the bill, they have to be more detailed in their presentation of finances to you. They give you a treatment plan with fees. The fee part of this treatment plan usually has 3 columns:
Column #2 and column #3 should add up to column #1. So, as you can see, the fee for the dental work will never be more than column #1. That is what the patient is ultimately responsible for. No hidden charges. The most common cause that leads to confusion and angry calls about bills is that most patients only look at column #3 and think that is all they will ever have to pay.
Check the treatment plan and financial agreement from the dentist. This is spelled out very clearly.
the problem is that they can always threaten to report me to the credit bureau if I refuse to pay.
They can and they will if you don't pay it. For one I would talk to the actual dentist or the owner of the practice and let them know what exactly happened. See if he/she will at least meet you half way for the cost of the treatment. Secondly, I would report them to the BBB and third never go back there!
Unfortunately this is a learning experience. In the future if you're not sure if a certain procedure is covered or for how much it's covered call your insurance company yourself.
Interesting how people keep mentioning the BBB. They are as irrelevant as the yellow pages these days. What are they really gonna do?
They will notify the business that the consumer is not happy with what they did and ask for restitution. It will also be a bad mark on their business practices. Some people still actually look at a businesses rating on the BBB before using their services.
They will notify the business that the consumer is not happy with what they did and ask for restitution. It will also be a bad mark on their business practices. Some people still actually look at a businesses rating on the BBB before using their services.
The consumer has (or will have) already done this. I'm not sure why someone would expect a different outcome the second time.
What makes you think you can dictate the payment terms of an outstanding debt with the dentist? You have to pay according the dentist's terms. If they are ok giving you an unsecured, interest-free loan (most are not), then fine. Most will demand payment in full, no other options. You've already burned any goodwill with them by not paying your bill for several months.
P.S. I have not met every single dentist in the U.S., but I will say with some certainty that none of them will accept a payment plan of $5/month on a $300 bill.
You can pay whatever you want... as long as you are making a payment they are unable to send you to a collection agency.. This is because you are making an attempt to pay your debt. They can not tell you how much you have to pay each month. If you call and make an arrangement then you would go by the arrangement but if you just send in a .50 cent check each month you are making an attempt to pay your bill.
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