Sunday, July 3, 2011

My dentist is charging me for work they told me my insurance company would cover.?

Ok, so I had some dental work done about 2 months ago. I had something like 7 fillings done which amounted up to about 1200 dollars. I aprooved the procedure and signed paper work saying that my insurance company would cover the other half. So I paid 600 bucks and got the procedure done. I then get a letter in the mail 3 weeks later saying I still owe 600 dollars, so I called the dentist office back and said "I paid my portion, my insurance is suppost to cover the rest." The lady frorn the dentist office says that my insurance doesn't cover white resin fillings so I need to pay the other half. I told her that the dentist office (infact I was her) told me that MY insurance would cover the other half, I said I wouldn't have gotten it done if they weren't going to cover the other half. So she says that they don't guarantee that my insurance is going to cover my half. So I said but your the one who told me they would cover it, the paper I signed said they would pay the other half. So I call my insurance and they say they don't cover white resin fillings, they said that its my responsibility to cover it. What the @$@# #%#@$%! How can they do this? Should I contact the better business bereu? Should I write them a letter? Get a lawyer? I called another dentist office and they said that's the secretaries fault for not researching it properly, then I called another office and they said "well u got the work done, you gatta pay" Please someone help me with some words of advice….
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With the dentist, I'm afraid you're going to have to consider it "lesson learned." The dentist's scretary is not an agent of the Insurer and thus cannot make peomises on their behalf. In the future, don't get anything done without a pretreatment estimate from your dentist and insurance company - in writing. I doubt that you can sue them (except perhaps in Small Claims Court), because no lawyer will take your case (they can't make any money on it). If you want to go the Small Claims route, it is possible that in the mediation phase (if that's they way Small Claims works in your jurisdiction) you may be able to get them to forgive part of the amount as a good will gesture. It would be a long shot, but perhaps worth trying. Now, as to your insurance company - you always have a right of appeal, so use it. The worst that can happen is that they will say "no." Unless, of course, your insurer is allowed to keep you out of court and use binding arbitration to resolve disputes. That isn't worth the risk, because if you lose in binding arbitration, you have to pay their lawyers. So read your policy/contract and make sure you meet any deadlines. You may also consult your state's Department of Insurance, if there is one.
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