quote:

Originally posted by Georgeair:
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.

They are in network. And I believe what you’re saying is correct. That’s what really frustrates me.

The thing is, I know the dentist. I like her. They actually just gave me bourbon and some accessories within the last couple of months as an appreciation thing.

It’s not enough money for them to be able to file it on my credit, so that’s not a worry.

I’ve cooled off a bit since I wrote my original post. I believe what I’m gonna do is sit down with the office manager and explain that I do not want to pay because of their failure to file in time, and if they absolutely insist I pay something I will pay what the contracted price with the insurance company is. And if they don’t agree to that I’m done. These procedures would’ve cost me absolutely nothing out-of-pocket if they had filed on time.

quote:

Originally posted by vthoky:
....and even now I drive an hour and a half each way to go see him twice a year.
....

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

I have you beat. Or at least I used to. I lived in Denver for many years, then started working projects and traveled (worked remote) and eventually relocated a couple of times. I kept my dentist until just recently, so my dentist visits took a week or more. (I couldn't just go to Colorado and ONLY see the dentist....)

quote:

It’s not enough money for them to be able to file it on my credit, so that’s not a worr.

What makes you think its to small of an amount not to send it to a collection agency? I switched my insurance company back in February and thought I was paid in full. I missed the first notice they sent but opened the second and they were threatening to send it to collections over a measly 11 dollars.

quote:

Originally posted by IntrepidTraveler:
so my dentist visits took a week or more. (I couldn't just go to Colorado and ONLY see the dentist....)

Nicely done, sir!

Medical billing is such a shitshow right now and only seems to be getting worse with bottom-of-the-barrel workers

A few years back our daughter fell down some stairs at my in-laws and fractured her arm and we took her to the ER and they ended up keeping her for observation overnight as they were concerned about a concussion. She ended up being fine and recovered quickly but then they billed us (HDHP) and we paid

Then they billed us again a few weeks later...and we paid

Then they billed us a few months later...and we paid

Then after over a year they sent us ANOTHER bill for thousands of dollars and said they messed up and sorry it's so late. My wife went She-Hulk on them and fought it and we didn't have to pay it.

It's a completely broken system.

quote:

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.

This.

quote:

My wonderful dentist that I hated to leave (moved a few years ago) is about 30 minutes from my house.

30min? I wish. I drive 1.5 hours one way for a great dentist. Topeka and Lawrence have crap dentists. My guy is in Overland Park, KS. When he retires I'll be on his porch.

The back office behavior gets more and more atrocious as there is more and more "vertical integration" with giant corporations swallowing once private practices. I've ranted in the pitch your bitch subforum more than once about its frustrating effects on being a patient.

My previous health insurance provider had a billing timeliness section in the contract to be "in network" as a medical practice. One of the medical practices back office fucked up and of course rather than honor their contract they tried to get me to pay. I involved the insurer who played the "wanna remain in network" hammer. They ate it and it went away. My employer switched health insurance providers after 20 years so eventually I'll probably have to find out if the new one has a similar timelines requirement for "in network" medical practices.

The other hammer, is Texas has a state law on 10-month deadline. 1st day of 11th month is last day or the medical provider has to bill it or they have to eat their screw up. Might be worth the OP checking to see if his state has a similar law.

Mine was the opposite. Last month I got a check for nearly $300. Some accounting issue. I called the office manager and confirmed it had something to do with insurance.

If you like your dentist, offer to split the bill.
My dentist of 20+ years is fantastic, it's 90 miles away. If the weather is good, I ride my motorcycle there to enjoy the trip.

The office manager or billing clerk should pay it. You paid for your insurance.

They screwed up. Not your responsibility to pay for their negligence.

I Always pay for my procedure before leaving the office. I got a notice in the mail about 2 years back that I owed for a balance of 480 dollars. So I called them up and told them I needed copies of every invoice I was past due on. Two weeks later I get another demand for payment so I called again and again asked for invoices. Got told the invoices weren't available. My reply was if they sent me another demand for payment for Fictional Charges I would be talking to the Local Police, the State, and taking them to Court for fraudulent demands. A week later I got a notification that my account was payed in Full.

All this started years ago with with insurance. I pay out of pocket and get a discount.

So, update…

Spoke with the insurance, they confirmed that the in-network requires the provider to bill within a year or the patient does not have to pay, per their legal contract.

Wrote a nice letter, dropped it off.

Office manager replied, saying they didn’t screw up, blamed it on the insurance, but as a courtesy they would waive the outstanding amount.

They included some submission records, which contradicted their own statement, and they were also “mistaken”, if I’m going to give them the benefit of doubt, on when they notified me of the situation, using a very key date.

Pissed me off with their deflection and erroneous date, and their snarky closing. I replied with proof of the correct date (coincidentally they emailed me about it the day of) which also negated their deflection, and said I will not accept anything less than a refund of the amount I paid on the original bill before I was aware of their mistake.

Keep in mind, not only did they fail to tell me about the problem, but they were aware of the problem, I now know, several months ago. And at this point, they have lied about when they first told me about it. And it is all clearly documented.

Again, my out-of-pocket, for this would have been absolutely zero if it was filed in time, or if they had let me know there was a problem and I could’ve fixed it with the insurance company before the one year mark. They did not tell me anything about it until after the one year mark. That is why the insurance company said that with the contract I am not required to pay anything. If they continue to press it after I try to reconcile it I need to file a complaint with the insurance company, per their request.

quote:

Originally posted by h2oys:
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.

And this was exactly the heart of my letter and attachments. Thank you for the suggestion.

^^^ You're most welcome.