Tuesday, December 28, 2010

Illinois Dental Office claimed procedures covered by insurance, then recanted after procedures were completed.?

Hello. We provided our dental insurance information to a dentist three weeks prior to any procedures being performed. The dental office stated that all procedures were covered by insurance. However, upon leaving the last procedure, the personal stated that each procedure that had been done cost an additional $100 over what the insurance covered. I even asked the employee why they did not inform us of this information prior to the procedures being completed. They had no answers for us, only that we had to pay $300 immediately. I was unable to do so, and so we have been sent to collections. I am looking for information as to if this is disputable. Any information will be appreciated. Thank you.
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The dental office can get preauthorization from your insurance to provide an ESTIMATE of coverage. (Notice how I emphasized the word ESTIMATE.) So this probably means that once they actually submitted the claim, the coverage wasn't as good as they thought. Another scenario is that the office raised their fees at the start of the new year. If this was the case, then they should have honored the original price they quoted you. You wouldn't have been sent to collections if you would have at least made and effort to pay the bill you owe or try to get a better explanation. It's not too late to figure it out. Good luck.
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