Tuesday, February 14, 2012

Life Lesson Number ???

(who knows - I've lost count!)

Today's lesson is about dental insurance... (and it's not the first time I have had dental insurance troubles. Too bad what I learned last time did not apply here!)

I am new to this place and looking for a dentist for the kids. One office I called did not treat children but recommended Dr. P's office. I called over, told them I was a new patient, and gave them my info. No problem. Here's an appointment, see you in a couple weeks.

At this point I am under the impression that they take my insurance. Which to me, an average, don't know much about insurance, consumer means that they will bill my insurance company and I will pay my portion of the bill, or co-pay. Out of network merely means that I will have to pay a higher percentage of the bill as co-pay.

What I come to learn later (MUCH later!) is that apparently this dentist is not only out-of-network, but they are non-contracted. Which means that they do not accept the insurance-allowed rate. They charge full price. Full price in this office is more than double what my insurance company has deemed allowable. To this dentist, "we take your insurance" means they will bill the insurance company and take whatever money they give us but will still charge you as much as we want. Insurance-allowed rate? What's that???

Did I mention that I have 3 kids? So that means that whatever happens for one, often happens to all 3 of them. At a minimum, I'm looking at 3 exam/cleanings. Turns out two of them also had cavities this time. (A little foreshadowing... a problem for one multiplies to a 3 times bigger problem!!!)

So the total sticker price for 3 cleanings and 5 fillings was $1844. After insurance and co-pays (including that I had already paid full price for Ryan's cleaning without realizing it) that left me with a bill of $820 still owed to the dentist. I went in this morning to plead my case and beg for mercy. Dr. P offered me a deal of $438 to clear my account of any outstanding charges. I took it. Learned another life lesson the hard way but thankfully paid less than I could have. Let this be a lesson to all of you out there - check, double check and triple check your insurance BEFORE you let them touch the patient!

I have a few excuses (no one made it clear to me in advance exactly what I was going to be expected to pay; my dog had just died at the beginning of the series of office visits; I had just moved my family across the country a few months before; my dearest husband had been out of the country for the past 2 months; I'm not in the insurance business-they are... the list goes on but those are the main ones!). I understand that I am partially at fault. However, I stand by my belief that both the insurance company (when I called them back in December wondering why they had sent the check to me, not the dentist!) and the dentist office staff could have been much better at communicating the insurance status and how that affects the charges for service.

I am also grateful that the dentist was willing to compromise and at least split the difference with me.

Can anyone recommend a dentist for the kids? I need a new one...

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