We went to a dentist who said they would accept our dental insurance. After we had our evaluations (since it was 2 years since our last appt. because we didn't have insurance, and can't afford dentistry without insurance) and 1 cleaning, we now have a charge of over $100, after our insurance paid their 100%. My husband still needs his teeth cleaned. We can't afford the bill, and want the dentist to waive it for us. Is there any information, or legal info about dentists can't charge more than what the insurance is paying them, if the insurance company is paying 100%? Please help!
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If they are a participating provider they are required to provide service at the rate they are contracted at. However, if they are not a contracted, participating provider, the insurance company pays a set amount and if the doctor's fees are higher than the amount the insurance company is willing to pay you are responsible for the difference. The best thing you can do is speak with the dentist. Most insurance companies will pay for one eval and one cleaning every year, some will pay every 6 months. That is per person. Again though if you are not seeing a participating provider then they can charge whatever their fee is and your insurance may not pay the whole thing.
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