Tuesday, July 12, 2011

Dentist said they participate with my insurance, but they don't. Now I'm stuck with the bill. What options?

My husband has been going to one dentist for years. This past November he had to get his widsom teeth out. They said they verified payment, but they must not have. Wisdom teeth extraction falls under medical, not dental, and they don't participate with my medical insurance. Now we're stuck with a bill for $2300 and I already paid about $500 out of pocket before the surgery. What can I do at this point? I never would have gone to them if I knew it wouldn't be covered. Do I have any recourse??
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First $2300 for IV sedation and 4 surgical extractions is very reasonable. The big problem is which insurance, dental or medical, is responsible for the bill. Is the medical and dental insurance the same company? Is this an HMO or PPO and you can only see certain providers? Either or both insurances should be responsible for the procedure. They are probably saying that you did not use one of their providers. Call their offices and file a grievance with them. Also send a letter to your state insurance commission (along with a copy to the insurance companies). You may have to fight for the payment but you should prevail. Good luck
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