What if payment is different from claim amount? (dentist, treatment, cover)

[Baike]

For claim details, there are two parts: Patient's responsibility and Benefit Paid.

For the dental clinic I went to, I made the payment immediately after the service, and the claim was processed a few days later. Now my payment is more than the amount I should be responsible on the claim form.

It is not big difference, around $30 only, should I contact dental clinic and ask my over-paid money back? I have not seen a dentist for years, and I am very happy with the service and professionalism. I guess I will visit the dental clinic for many years ahead. It is two different things, but I don't want to give me "bad" impression when I ask money back, since I will visit the dental clinic again in the future.

I am 100% sure I over paid. It has been 2-3 weeks since claim form was processed, and I can wait longer and see if dental clinic will refund the over payment amount. If they don't issue refund check, should I ask and request for refund?

Thanks.

[beezle1]

Yes, contact the dental clinic. This happens fairly frequently. They may send you a check, or they may suggest holding the funds and giving you a credit for later appointments.

[Baike]

Originally Posted by beezle1

Yes, contact the dental clinic. This happens fairly frequently. They may send you a check, or they may suggest holding the funds and giving you a credit for later appointments.

If I don't receive refund check, I will talk to them next time when visiting the clinic, but next appointment is a few months from now. Next appointment is routine check, I don't expect any dental work, I am expecting that next appointment will be 100% covered by my dental insurance plan. So I still have credit on my account after next appointment.

Hope they will send me a refund check.

[Parnassia]

Originally Posted by beezle1

Yes, contact the dental clinic. This happens fairly frequently. They may send you a check, or they may suggest holding the funds and giving you a credit for later appointments.

This has happened to me a couple of times. At the time of service, the practice estimates what your insurance will pay, but once the company cranks the numbers, it may end up being slightly different.

[Baike]

Originally Posted by Parnassia

This has happened to me a couple of times. At the time of service, the practice estimates what your insurance will pay, but once the company cranks the numbers, it may end up being slightly different.

So did your dental clinic issue refund check to you by itself?

[irootoo]

This happens to me all the time. The dental office just sends me a check for the difference, without my having to request it.

[Parnassia]

Originally Posted by Baike

So did your dental clinic issue refund check to you by itself?

No. They credited the small amount toward another appointment that had already been scheduled.

[KKANEHI]

I had this last year after going and getting some periodontal done. It seemed odd that my insurance had paid the amount agreed and the dentist still charge beyond that. I was $180 in total over the agreed amount. Long story short about a month after the treatment and insurance had paid I got a check for $180 from the periodontist. Hope it works out for you.

[toofache32]

If you actually read the paperwork given, it says that the amount you pay is an ESTIMATE and subject to processing of the claim.

[toofache32]

Originally Posted by KKANEHI

I had this last year after going and getting some periodontal done. It seemed odd that my insurance had paid the amount agreed and the dentist still charge beyond that. I was $180 in total over the agreed amount. Long story short about a month after the treatment and insurance had paid I got a check for $180 from the periodontist. Hope it works out for you.

The dentist didn't "Charge" above the amount paid by the insurance. The dentist simply submitted their regular fee since they don't know exactly how much the insurance will pay.