Dental insurancce, Dentist fraudulently over charged for performed service.?
I really think my dentist is charging me twice for the same dental service render. A while back I moved to far to keep the dentist I always had. So I pick another dentist that was part of my PPO plan that I get though my work.
I went to there office and had a root canal and crown down. Under my plan my co-pay is 50% I was told at the time I only had to pay the $50 deductiable and they would bill me for the balance once the insurance company paid. From what they did tell me the total cost for everything was $1285.00.
Yet into days mail I got a billing statement for $900.00 this is like $260.00 more then what it should be. I called the dental office and they like that what is left after the insurance company paid. This does not add up to the 50 percent that would have gotten paid. How do I get this corrected?
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Friday, Sep. 24th 2010 3:16 PM at 3:16 pm
Before going off on the dental office for over payment call your dental insurance company find out what they may have gotten billed for and see if it was the $1285.00 or not.
If it was a higher billing then call the dental office to find out why. If it was the $1285.00 then find out from the insurance company why they did not cover the total 50 percent.
Possible reason may be that the charge was over the UCR rates therefore leaving you a higher balance then you thought.
Friday, Sep. 24th 2010 3:23 PM at 3:23 pm
I had that happen to me before and I found out that my dentist did not over charge me but I was told by my dental insurance company that he was to expensive and was over the fair and reasonable cost.
The only way to avoid that from happening again was to submit the claim prior to the work being done in order to confirm what my plan was really going to pay out on my dental services.
I would first call the insurance company. It only odd that normally when you are staying within the plans network of provider the dentist should be with the companies fair and reasonable guild lines. So make sure you ask about that.