In-network dental office “forgot” to file claims for three routine visits for over a year.

When submitted earlier this month by the dentist’s office they were summarily denied due to being too late.

I never received any notice prior to a letter I got with the balance due this week. And we’ve made multiple visits since then that have been filed and paid by insurance.

The rates for the procedures (cleanings and Dr exams) listed for payment were the dentist’s rates, and not the insurance in-network allowed rates.

The bill is $250, so it’s a principle thing as much as a monetary thing at this point.

Planning to send a polite letter telling them to bugger off and write it off because no matter what “agreement to pay” I have signed, I ain’t paying that shit that exists only because of their incompetence.

This message has been edited. Last edited by: chongosuerte,

Nope.

I fired my long time dentist last year for something similar. Their office manager left a couple years back, and the dentist's wife took over. Billing has been a total dumpster fire ever since. After several screwups along the line of yours, I was done with them, despite really liking the dentist himself.

Nope. Medical and dental billing / scheduling has become a disaster!

Does your dentist have an office manager? Chances are they do and I would talk to the person. Explain the situation from your point of view and agree to pay for what would have been your copay. I think that’s fair.

The dentist more than likely just outsource the billing function to a third party. You want to talk to a person who can talk to that billing function.

If you like your dentist and you owe the $$$$$ Id just pay it or pay the portion you would have paid after insurance. Mistakes happen and just because there was a delay in billing the insurance company doesn't mean you don't owe the money. If you do refuse to pay might be a good idea to find another dentist. I wouldn't want a disgruntled dentist digging around in my mouth.

Yep, if you like your dentist, pay it. The good ones are hard to come by. I would then follow up after visits to make sure shit is getting claimed

Nope! They, not you, effed up.

Yes.

Nope. That’s their mistake. They fucked up and that’s on them. YP, not a MP.

I should add that my cost out-of-pocket would have been zero. These cleanings and Dr examinations would have been covered 100% by my insurance if they had followed it on time.

Several subsequent visits have been filed/paid, and copays for procedures not covered 100% have all been paid.

I don’t particularly love this dentist office, it’s just three minutes from my house. My wonderful dentist that I hated to leave (moved a few years ago) is about 30 minutes from my house.

Having a good dentist is important to me. After a move I was an hour and a half from the one who cured my phobia about dentists, and I continued to see her despite the drive. Fortunately after she retired my current one is five minutes away. A couple of friends drive an hour to come here.

quote:

Originally posted by chongosuerte:
I don’t particularly love this dentist office, it’s just three minutes from my house. My wonderful dentist that I hated to leave (moved a few years ago) is about 30 minutes from my house.

I offer this in good fun, rather than as a stab at you or anyone else: My dentist has been my dentist since I was about 9 years old. He’s great. I’ve moved several times since leaving my home town, and even now I drive an hour and a half each way to go see him twice a year. I won’t change dentists until he retires, and I’ve told him so. He assures me he’ll be working a good many years more. (He’s got expensive hobbies.).

My crew at work says, “man, when you go to the dentist, you’re gone half the day!”

I would ignore the bill. Your obligation was to pay any copay and provide insurance coverage for the balance, which you did.

They fumble-finger their end...that's on them.

I wouldn't bring up the subject, I'd just ignore the bills. If someone at the practice asks in person, that would be the time for discussion, and it'd be a short discussion: "Seems to me that was a billing mistake on your end. I paid what I owed at the time. Feel free to pursue any balance with the relevant insurer. Is there anything I can do to help you with that?"

If insurance processed it, I would pay what I owed. The fact that it is late wouldn't be terribly relevant.

HOWEVER, since it sounds like them screwing up also screwed the insurance process, then hell no I wouldn't pay it.

I do my best to not pay for the mistakes of others.

Was the dentist considered in-network by your insurance carrier?

If yes, just send your insurance carriers EOB to the dentist, highlight/circle the spot where it says you owe $0, make a copy, and mail it to them.

That should be the end of it. If not, contact your carriers provider relations department, give them a copy of your mailing, include a copy of the original exterior stamped envelope, and they will take care of it for you.

All very hands off/non confrontational for you, and professionaly handled.

quote:

I don’t particularly love this dentist office, it’s just three minutes from my house. My wonderful dentist that I hated to leave (moved a few years ago) is about 30 minutes from my house.

You can't drive 30 minutes to see a dentist you liked and took good care of you?

quote:

Originally posted by joel9507:
I would ignore the bill. Your obligation was to pay any copay and provide insurance coverage for the balance, which you did.

They fumble-finger their end...that's on them.

I wouldn't bring up the subject, I'd just ignore the bills. If someone at the practice asks in person, that would be the time for discussion, and it'd be a short discussion: "Seems to me that was a billing mistake on your end. I paid what I owed at the time. Feel free to pursue any balance with the relevant insurer. Is there anything I can do to help you with that?"

I don't know if ignoring the bill is wise since it's likely the bill will be sent out to a collection agency if it goes unpaid which creates more problems.

I changed dentists once due to the office staff being incompetent. The practice lost their original office manager and her replacement was an idiot. I liked the dentist though.

Gave them a second chance after the first “mistake”, double dipping. They sent me a bill for services that had originally been paid for by my insurance company saying that the claim was denied. When I took the insurance carrier”s statement they backpedaled and “apologized” for their “error”. I let it go figuring mistakes can be made.

Second time was the end. Went in for a six month exam and cleaning. They set the next appointment date, unfortunately the date they set was two days shy of six months, this is after I told them “Make it a Saturday and make sure it’s over six months from today” . So, that claim got denied once submitted.

I went in with their statement and the denial of payment letter from my insurance company. We went around, the new (manager of the month club I assumed) office manager, English language was not one of her attributes. She threatened me with a collections agency, I responded with threat of a Small Claims Court case.

Final disposition was they wrote it off. Their mistake, not mine. Never returned after that.

If they are truly in network via contract with carrier, I suspect that agreement prevents them from “balance billing” you for amounts denied by carrier.

quote:

Originally posted by chongosuerte:

I don’t particularly love this dentist office, it’s just three minutes from my house. My wonderful dentist that I hated to leave (moved a few years ago) is about 30 minutes from my house.

I would refuse to pay and contact the office manager. But I wouldn't let it go to collections or in any way impact my credit score. I wouldn't stay with that practice after having a conflict with them.

I drive 45+ minutes each way for my dentist. A good dentist is worth the drive a couple of time each year.