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Old 06-09-2019, 11:15 AM
 
Location: Florida
7,628 posts, read 13,540,311 times
Reputation: 10222

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I recently had 2 teeth extracted due to an infection. I was given the referral from the General Dentist. So the Oral Surgeon knew an exam had been done, and what teeth needed extraction. He also had access to those Xrays and diagnosis.

The teeth were pulled and the charge was $531. I was told my copay was $250. I paid it went on my way. I got a bill Friday from the oral surgeon wanting $60. My Met Life Dental paid $221of the charges. Met Life has told me the Oral Surgeon charged for another exam, even though it had obviously been done by referring dentist. Another one did not need to be done, so Met Life denied that portion of the claim.

I'm curious how others would feel. Just pay it? Question the why since he had complete access, to the other exam done 2 days earlier?

My view is many Dentist are out for the buck. Will do like this one repeat exams, or procedures even if they are unnecessary.

I probably would just pay this, but Met Life telling me a 2nd exam was not necessary for this extraction. Well that bothers me. I'm not very impressed with the local dentist to begin with. If anyone reading this lived here, they could see why. Thanks
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Old 06-09-2019, 11:32 AM
 
Location: Alexandria, VA
12,585 posts, read 22,437,679 times
Reputation: 19388
What does your EOB say you owe?
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Old 06-09-2019, 12:22 PM
 
Location: Michigan
2,584 posts, read 1,956,462 times
Reputation: 6181
Pay it, and never go back to that oral surgeon. Basically, it's the same thing with medical insurance. You are on the hook legally for anything the insurance doesn't pay. There's no way you can PROVE the second exam wasn't needed.

It sucks to have to pay the extra $60, but you can't hire a lawyer for that price, nor is it worth your time to deal with a collection agency dunning you for it for the next 7 years. Medical collection companies, never easily quit.
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Old 06-09-2019, 02:03 PM
 
Location: on the wind
12,763 posts, read 6,277,227 times
Reputation: 42012
Quote:
Originally Posted by Jimrob1 View Post
I recently had 2 teeth extracted due to an infection. I was given the referral from the General Dentist. So the Oral Surgeon knew an exam had been done, and what teeth needed extraction. He also had access to those Xrays and diagnosis.

The teeth were pulled and the charge was $531. I was told my copay was $250. I paid it went on my way. I got a bill Friday from the oral surgeon wanting $60. My Met Life Dental paid $221of the charges. Met Life has told me the Oral Surgeon charged for another exam, even though it had obviously been done by referring dentist. Another one did not need to be done, so Met Life denied that portion of the claim.

I'm curious how others would feel. Just pay it? Question the why since he had complete access, to the other exam done 2 days earlier?

My view is many Dentist are out for the buck. Will do like this one repeat exams, or procedures even if they are unnecessary.

I probably would just pay this, but Met Life telling me a 2nd exam was not necessary for this extraction. Well that bothers me. I'm not very impressed with the local dentist to begin with. If anyone reading this lived here, they could see why. Thanks
Met Life was not looking in your real time mouth before starting to cut. The oral surgeon was. Yes, they had the imagery and diagnosis from your general dentist, but I think I'd want a referral surgeon to double check what else might be going on with the real patient they'd never met before prior to starting their work. There may have been something on the available imagery that wasn't clear, and those images won't show soft tissue issues that might alter the plan. Charging a mere $60 to be conservative and cautious seems like a bargain to me.

Last edited by Parnassia; 06-09-2019 at 02:49 PM..
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Old 06-09-2019, 02:08 PM
 
Location: Coastal Georgia
41,014 posts, read 50,759,227 times
Reputation: 70769
When I had my last Crown, which was a replacement, the dentist said he had to provide before and after xrays to prove to the insurance company that the new crown was needed. I’d blame the hoops your oral surgeon had to jump through on the insurance company.
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Old 06-09-2019, 02:47 PM
 
Location: Southern California
28,803 posts, read 11,446,625 times
Reputation: 18462
OP: I come from a Senior Low Income status and depending how strongly I feel about that $60 and that I don't owe it, I would talk to the billing dept and if that fails, agree to pay 10 or so a month...I love staying away from docs and dentists...none of this stuff to deal with. In my years of a lot of dental work, things were so much easier financially....now it's out of sight. I have done with with other outstanding bills and they just deduct from my debit card what I say I can pay...but this is me.
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Old 06-10-2019, 12:24 AM
 
Location: Living rent free in your head
37,913 posts, read 17,750,568 times
Reputation: 27853
Quote:
Originally Posted by Jimrob1 View Post
I recently had 2 teeth extracted due to an infection. I was given the referral from the General Dentist. So the Oral Surgeon knew an exam had been done, and what teeth needed extraction. He also had access to those Xrays and diagnosis.

The teeth were pulled and the charge was $531. I was told my copay was $250. I paid it went on my way. I got a bill Friday from the oral surgeon wanting $60. My Met Life Dental paid $221of the charges. Met Life has told me the Oral Surgeon charged for another exam, even though it had obviously been done by referring dentist. Another one did not need to be done, so Met Life denied that portion of the claim.

I'm curious how others would feel. Just pay it? Question the why since he had complete access, to the other exam done 2 days earlier?

My view is many Dentist are out for the buck. Will do like this one repeat exams, or procedures even if they are unnecessary.

I probably would just pay this, but Met Life telling me a 2nd exam was not necessary for this extraction. Well that bothers me. I'm not very impressed with the local dentist to begin with. If anyone reading this lived here, they could see why. Thanks
If the dentist was part of the MetLife network then the dentist should accept what the insurance company allowed and your only charge should be the co-pay and any deductible. If they aren't part of the network you will probably have to pay the $60 but why not call MetLife and talk to them?
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Old 06-10-2019, 04:44 PM
 
Location: Florida
7,628 posts, read 13,540,311 times
Reputation: 10222
Thanks everyone for your comments. I paid the Dentist today, and left it at that. I miss the dentist I had before moving to Fla. I was comfortable with his practice. It felt stable and professional. I didn't have to wait months to get a cleaning Appt. The Dentist at least in this area of Fla, just seem to operate, like a fast food restaurant. Mobs of customers. The employee takes your money, and they don't care if you will be back. I've never seen anything quite so obvious.
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Old 06-11-2019, 10:36 PM
 
1,572 posts, read 2,108,686 times
Reputation: 2455
You don't want the person doing your surgery to examine you prior to surgery? Do you really think there is a surgeon who will operate on someone without examining them first so they can make sure they can complete the procedure successfully, and discuss the procedure, the potential complications, and what to expect after surgery?

You should be upset at your crappy insurance for looking for a way to not pay for necessary services. This is how dental "insurance" works. It's not really insurance. It's just a gift card for certain treatments for a limited number of times. Why aren't you upset with the general dentist who charged you for an exam when he was not able to provide a solution and had to refer you out? Did he waste your one time exam??
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Old 06-11-2019, 11:39 PM
 
Location: Avignon, France
9,581 posts, read 5,334,845 times
Reputation: 24092
I have never in my life heard someone say that they had good dental coverage and never had to pay a penny out of pocket to make up the difference... NEVER!
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