Dispute dental cleaning bill: in-network, high charges?

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  • #93656 Reply

      Good morning, has anyone been able to dispute a bill from a dental place. We went in for regular teeth cleaning, nothing else and now they sent us a bill. I have never paid for regular cleaning for dental before. It has always been covered by our dental insurance. We recently moved and this is our new dental place. It’s in network.

      For a family of 4, we sent us a bill about $800. They charged us differently for each person although we received the same teeth cleaning. I called and they said maybe the insurance didn’t pay all of it. I looked at what they charged and it seemed an outrageous amount that they billed our insurance.

      So our insurance only paid a portion. It doesn’t make sense to me that they are double dipping. Even with regular teeth cleaning without insurance I was quoted from another dentist as under 800 for a family of 4 (I called another dentist after getting this bill).

      Anything I can do or just have to pay their bill? Thank you for your help.

      #93657 Reply

        If you went to a new dentist, you most likely each had a comprehensive exam (very few offices will do a cleaning without ever having had an exam with the dentist).

        Insurance will usually only pay for one every five years, so if they had already paid for one within that time span, they probably denied the charge, and that would most likely be the reason for most of the bill.

        The best way to better understand the cost would be to get a printout of the codes used and call your insurance to see why those individual codes weren’t covered.

        #93658 Reply

          Most only pay cleaning after 6 months. If you went 2 days before the 6 month mark from you last cleaning they will not cover it. That may be it.

          #93659 Reply

            Your insurance company should have sent you an EOB (explanation of benefits) it will show how much you owe and why they might deny paying something. You should never owe the difference if they are in network. I wouldn’t pay anything until you understand everything.

            I also wouldn’t go back to that dentist. Get a referral from someone you trust.

            #93660 Reply

              Check your EOB. If the dentist is in network, they are bound to charge what is required by the insurance company and there is a max allowed.

              #93661 Reply

                if they are in network pull the EOB from the insurance website to see what they covered and didn’t to figure out if something was incorrectly coded and should have been covered but wasn’t. ask your insurance why any charges weren’t covered. if everything is covered then the office should not be allowed to double dip per contract if in network but if out of network or it’s actually a dental discount program and not true insurance then they can.

                #93662 Reply

                  Did you confirm with the insurance co they are in network or the dr office told you that? I once had this issue because my husband called the dr office to set up apt and ask if they were in network. The dr office told him they take our insurance. So he assumed that was them confirming they were in network.

                  I called them and pitched a fit when I got them bill, told them I would not pay and they reluctantly $0 the balance which was less then $200. This was several years ago and we switched drs.

                  But I would suggest you call your ins co. If you find out the dr office did not accurately disclose charges in advance then I would confront them.

                  #93663 Reply

                    If you were my patient I would invite you to come in and review the insurance benefits and bill in person with our insurance coordinator. I recommend you request this from the dental office.

                    #93664 Reply

                      For context, I was quoted at $454 for an initial visit and cleaning at my local dentist. It seems to be standard in the industry to charge an exorbitant sum for initial exams, X-rays, and cleanings.

                      #93665 Reply

                        Was in a similar situation. Called the dentist first, no help.

                        Called insurance, they told me to call the dentist.

                        After several rounds of going back and forth, I wrote to the American Dental Association. Their website allows you to submit complaints and they will investigate.

                        So, I did that.

                        3 days later, I received a letter from them saying that there is nothing they can do.

                        I have given up and best I can do is not go back to that dentist again.

                        #93666 Reply

                          I took my kids for a routine visit and it wasn’t covered for one because she had already used her two visits for the year. The charge was $37. I agree that something is out of line with the amount you’re being billed.

                          #93667 Reply

                            Your Dentist’s Office needs to resubmit. Someone entered the wrong Codes. There is a difference for Child Prophy vs Adult Prophy. Recare Visits are usually covered every 6 months for most Instances.

                            #93668 Reply

                              I was recently quoted almost $1000 for a procedure for my daughter. I called Cigna and reviewed the codes. They told me that my out of pocket should be $240. The dentist had wrong estimates for insurance and was trying to charge me over the negotiated rate, which Cigna does not allow.

                              Cigna did a 3 way with me and the dental office and got it straightened out. I can’t believe I would have paid over $700 more, had I not checked.

                              Also, Cigna said if I was ever overcharged, to contact them and they can still go back and work with the dentist’s office on my behalf.

                              #93669 Reply

                                Dental insurance companies are just for-profit machines. They have so many dumb rules designed to get them out of paying when you have work done, even though you pay them your premiums every month. Best just to find a dentist that you trust and get along with, whether in or out of network, and just view your dental insurance as a “coupon” for any treatment you have done, and consider yourself lucky if they cover anything significant at all.

                                #93670 Reply

                                  I had something happen once where the dentist was basically scamming the insurance. They charged for any little thing they could. I would review the EOB carefully and see if there are things charged that you didn’t receive. Then threaten to let the insurance company know and I assume they won’t make you responsible for your bill.

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