One plan is a PPO at 100% coverage up to $1500.00. The other is an HMO with copays. My dentist is charging both companies for my daughter's root canals. They charged both companies for my 4 crowns AND they want me to pay $750. Are the companies being robbed? I think I am being robbed as well! What do I do?
--------------------
No, the companies are not being robbed. And neither are you. You have what is called dual coverage. Your dental office will bill the primary carrier first, then submit the claim to the secondary carrier. Usually there is a small balance after each insurance company has paid. Your balance of $750 seems reasonable, and actually, even cheap for 4 crowns and a root canal. One way to be sure that neither you, or either of your insurance companies are being "robbed" is to go over the EOB (explanation of benefits) that each company MUST send to the insured person. Compare both of those with what your statement from the dental office says. If you see a discrepancy, call the office and ask for an explanation. If you do not have the EOBs, call either the insurance company or the dental office and ask for a copy. EDIT: both plans are supposed to be billed the entire amount. a dentist must charge the same amount to each insurance company. first it is sent to one insurance, then it is sent to the other with a copy of what the first one paid. this is normal. Look over your EOBs to make sure that everything looks the same on them and on your statement I hope this helps you to understand. I know it is confusing. You can also ask the office staff to help you understand. that's what YOU pay them for. they work for you.
Source
No comments:
Post a Comment