I would never expect my dentist to charge me illegally, but that is exactly what happened.
This goes to show why it is imperative to read every type of bill, in detail. I will explain what happened in hope that my experience might help save someone else money.
CONTRACT BETWEEN INSURANCE COMPANY AND DENTIST
The dentist has a contract with “approved” insurance companies, in my case, Delta Dental Insurance.
The dentist sends the bill to the insurance company. The insurance company has a limit for the max they will pay for each given procedure.
In my case, Delta Dental Insurance pays 100% for preventive care, such as teeth cleaning.
After receiving payment from Delta, my dentist sent me a bill for $60. Why? Because that was above what Delta was willing to cover. But wait!
I called Delta Insurance and learned that their contract DOES NOT ALLOW the dentist to charge the patient more! So their bill for $60 was illegal, according to their contract.
Delta Insurance offered to call the dentist for me and inform them they could not bill me for $60. The dentist’s employee told Delta the $60 was a “balance forward.” But that was FALSE.
At the top of my bill it said: Balance Forward $0. Plus, if I had owed money, they would have been asking me for payment.
So then I called the dentist to get that false and illegal $60 bill removed. She said, “I will remove the $60 but you still owe $10.”
“What is the $10 for?” I asked.
“A PPE fee. That is for extra Covid precautions.”
“You mean I have to pay for your Covid masks?” I asked, incredulously. “That was not on my previous bill.”
“Yes,” she said. Now I was even more annoyed! Why were they adding a new fee? Like a junk fee?!!
I called Delta Insurance again. The insurance agent laughed and said, “They are not allowed to charge you any PPE fees for Covid-related expenses. At the beginning of Covid, I sent out a memo telling them how to handle PPE fees.”
Now I called the dentist again. This time I said, “Who is the top person in charge of billing?” She gave me the name April. “I want an appointment with April,” I said. “I am coming in to straighten out my bill, because it is a mess.”
Two days later, I went to my appointment with April. Guess what happened?
April started off my saying, “Let me first apologize to you.” She said she reviewed my bills going back to 2019 when they went on a “new billing system.” Then she handed me this check for $209.70.
They had been illegally sending me a bill for the difference between what the insurance company allowed (and paid) and what they wanted to charge (over-charge). Not knowing it was illegal, I had always paid it.
But because of that stupid $10 PPE fee and my insistence on speaking with the person in charge, I received a nice refund check.
I wonder how many other dental patients are owed a refund but who will never receive it, because they don’t question their bill or call the insurance company and ask.
Wow I will certainly be checking My bills going forward
That is a good idea.
Excellent information!
Thank you, Marthalee.
Wow. This was a most interesting read…
Thank you very much for sharing…Wow, justvWow!
I know! My husband said, “You practice what you preach. You read your bills and you don’t stand for nonsense fees.” I took that as a nice compliment.
I was charged the PPE fee of $10.00 The dentist assistant made it sound like it was mandatory.
The dental assistant at my dentist also said it was “mandatory according to state requirements.” Turns out that was false!
Call your dental insurance company and ask. The insurance company is the final authority, because they and the dentist have a legal contract if they are on the Preferred Provider List.
When the audit was done on my account, not only was the $10 refunded, but another $40 PPE fee refunded, plus other overcharges that added up to more than $200!!
Do you still coming back that dentist even after they overcharged you?
That is a good question! At first, my intension was to find a new dentist. But then I thought about it and realized that it was not the dentist’s fault that the billing department messed up. He is such a good dentist. He never tries to tell me to get extra work done that I don’t need. He explains everything thoroughly. He is very respectful of my need for no pain (or as little as possible). So after I received a very sincere apology from the head of the billing department and a refund check, I decided to stay with the dentist. I am happy to tell you no more billing errors have happened.