Sunday, June 26, 2011

Question about an unexpected dental bill?

I have a friend who has gone to the dentist several times in the past year to get extensive dental work done. She doesn't speak very much english. Recently she was told that she would need to get a root canal done. She asked the doctor how much it would cost and she was told that they won't find out until they bill the insurance company. She had the work done and then she got a huge bill where her insurance only covered about 10% of the work because at this point, she had already maxed out her yearly coverage. We went back to the dentist together and we were told that they never know how much any of the work will be until the insurance claims are processed and that they could only provide an estimate. However, even when she asked for an estimate, they didn't even give her one. All they told her was that she didn't have much of an option and that she needed to get the root canal done right away or else it would cause her more trouble. Now she is stuck with a huge bill and she can't afford to pay it. Someone told me that it is against the law for dentists to bill customers without sitting them down first and explaining what the costs are going to be. Does anyone know anything about this and have any advice on what our options are?
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the explanation of her dental insurance should have been a conversation between her and her dental insurance not between her and the the dentist, although most dental offices go over it with you to some degree. But you are right, the cost is usually an ESTIMATE only. AND if she filled out the health history and signed at the bottom, most health histories has a clause that she is entitled to pay the bill no matter what the insurance pays. just like you are in an auto collision, the auto insurance is who you talk about payment, not the repair shop. A repair shop also calls you with an estimate only. But you are responsible for working out payment with your own insurance company. it is up to the consumer to know about their own health/dental insurance policies and not the job of the dental office to figure it out for you. her Human Resource manager or the insurance company should be able to provide a booklet of benefits and details of the maximum allowable benefits. i find that when someone has a bill in their hand, that is the first time they actually look into their policy.
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