I had periodontal treatment in early December 2009 and paid over $1100 for the services with the rest to be paid by dental insurance? I received a Explanation of Benefits that said I was only responsible for $903. I called my insurance provider and the customer service representative said I should receive a refund for the overcharges. He also charged me $75 for an initial consultation earlier, but said they would file with my insurance. Insurance paid $260 and said that my out of pocket costs were zero. I sent a letter to my periodontist, but have not received a refund for either the initial consultation or the over $200 in overcharges. What should I do now? One friend suggested filing a letter of complaint for insurance fraud with the state dental board.
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Don't panic yet. You're talking about something that started last month. Insurance and medical paperwork can take several months to settle. Plus with the Holidays, a lot of billing employees take their vacation. Offices might be closed for 2 weeks. Then, as work resume, they are tons of paperwork to catch up...until they get to yours which is a more complicated matter if you overpaid and have to be issued a refund. Sometimes, I just drop the matter, because it's like $30 that I overpaid...then 2 years later, I get a check in the mail! Do not assume they're any fraud anywhere, just know that things are very slow regarding these matters. Keep on top of it (make a detail file) but be aware that letters get piled up in other piles while a direct phone call, keeping good notes (name of the person, dates...) can yield faster results since the person will make your case a priority if you talk directly to him/her.
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