Saturday, May 15, 2010

My dentist wants me to pay up front and have my insurance company reimburse ME?

I just went to the dentist today and had a filling. I have dental insurance, but the dentist wanted payment up front for the services.

The receptionist said they require payment in full for the services on the day of service, and then they will send the insurance claim in to the company and eventually I will receive a reimbursement check.

Isn't that what INSURANCE IS FOR??? So you DON'T have to pay?????

I don't handle the cash in my family, so after much arguing about requiring payment up front, the receptionist agreed to let me walk out withouth paying, but expects me to have my husband pay by tomorrow.

It just doesn't seem right that the dentist gets cash up front for the work, and then makes ME wait to get reimbursed by the insurance company... what the heck?

My dentist wants me to pay up front and have my insurance company reimburse ME?
If your dentist is not a "Participating Provider" the insurance check from Blue Cross Blue Shield is automatically sent to the subscriber. Most offices work similar to what your dentist does, but usually they require 50% down and the remaining balance at the time of insertion or completion. The insurance cannot be submitted until the work is complete and Blue Cross Blue Shield usually pays within 7 days. They are one of the fastest insurance payors I have ever dealt with. They will not pay for all your procedures at 100% though, so you won't receive a check reimbursing you the entire cost and they usually have a $1500.00 calendar year maximum.

Dental insurance is not medical insurance so most offices are similar to the one you are going to. Some offices have these policies because patients have taken the insurance money and never paid for the services rendered. People don't realize how far they are asking their dentist to trust them. In our office if you are an established patient for a couple of years we will allow payment plans, but they are usually only 3-6 months out, anything longer and people tend to forget to pay us and then we end up sending the account to collection.
Reply:Not all insurance companies work this way, but it is not unheard of. I once had dental insurance that worked the same way.
Reply:call the insurance company. dont do that. It might be a rip off. Maybe the insurance doesnt support that dental center. I would check with my insurance or Medicaid.
Reply:it can work either way, but this is your own fault. You should have checked with them before beginning treatment to determine their policies.
Reply:It's the doctor's business and he can require payment in full if he wants - but I would shop for another dentist that will accept your 'estimated' portion. Once insurance settles with the dentist, you will be billed for anything remaining.
Reply:Sounds like you have Delta Dental. Some insurances take so long to pay the bills that the dentists don't want to wait that long for payment. Therefore they want you to pay and you to wait for the reismbursment.
Reply:you are very naive--would you work for someone,and wait to be paid by someone else???-i think not
Reply:I've had that happen before. I would make sure you tell the ins. co. about this. Usually when a claim is made the dr won't tell the co. that they already got paid, so then they get money twice. I'd make sure you never use this dentist again. Also keep calling the ins. co. to track the claim so that you make sure you get your money back.
Reply:It depends on your insurance on how they do it. Some companies only reimburse you after the initial visit (like yours) and others will pay the whole amount or a percentage. It could be that you went to a dentist that was out of network and that is how your insurance company handles out of network dentists. I would recommend checking with your insurance company to make sure that the dentist office was correct and go over your coverage.
Reply:they can do this, some doctors area asking for payment at time of service weather you have insurance or not.

you need to ask them for a discount if they are asking for this, reason being if you have to file all the paper work and wait for payment then ask if they will give a discount. if not, since you have already had work done and your Friend got you out the door, just let them know you don't have the money but can pay your co/pay (if any) and pay you when you get insurance money, it's worth a try.
Reply:Alot of dentist are that way now. But if you have insurance you shouldn't have to pay up front unless the insurance doesn't cover the entire amount. Even then sometimes they get the amount wrong and you end up over paying. Sometimes if you talk to the dentist and not the receptionist they are more understanding since they get paid to be like that so they get their money. I would look for a new dentist if that's how its gonna be.
Reply:Everyone has their own billing policy. Why shouldn't he get paid for his work right away...why should HE have to wait? Read your insurance (if you can) and you'll get the idea that they are in contract with you, not him, and he is not obligated to accept payment first from them and then the remainder from you. time discuss billing arrangements with a dental or medical professional BEFORE they render services to you...that way you won't have any unexpected (although totally legal) surprises...

P.S. You don't handle cash?? Your husband does??? Honey, your teeth are apparently the least of your problems, then...yoy!
Reply:A lot of dentists and doctors are doing that now...they are tired of waiting for the insurance to they want there payment in full, it is stated on the desk, door, wall....whatever...See someone else if you do not like to do this...sad thing is this is the way they are trying to go, some insurance companies do not pay a bill for 6 months...and that is why they are fed up with them...It's no big deal if you pay up front or not, you will get reimbursed, after you fill out your paperwork as well of course...
Reply:Unfortunately, many insurance companies will nit pick with the doctor or dentist over valid charges. They do not have the manpower to have a full time person deal with these issues...if they did, your rates (and mine) at the office would go up to cover the pay for that person or persons, whichever the case may be. Your insurance company is probably known for not paying up properly and in a timely manner.

They will let you send the claim and if the insurance company wants to be poopy about things, then YOU deal with it.

You ARE still insured, you just don't get the money up front and this is becoming more and more common as insurance companies think of new ways to bilk doctors and patients.

Sorry. Welcome to the US health care system.

The people you need to be upset with are the ones at the insurance company, not the doctor/dentist.

This is rather common, I am surprised you haven't run into it before.....
Reply:I don't know as much about how this works for dental insurance as i do for medical. It's what is called Not Accepting Assignment which basically means the provider doesn't want to deal with the insurance, they might fill out the claim for you but after that it's your problem.

This is only allowed for out of network providers on a PPO type plan. Your best option is to call you insurance company, find out if this dentist is in network. If not find one who is, for this specific bill, if you can afford it pay it and be done. If not file your claim wait till you get the check from the insurance company and then pay it. The dentist office can't do anything to you but send you bills for the first month or so anyway.

If they are in network then they're really jerking you around and your insurance company does some leverage with them to make them accept the insurance.
Reply:Because now a days insurance companies are slack on paying dentist, doctors, and the like. Alot of medical and dental practices are like that.
Reply:Well try to see other over point of view here . They have to pay rent - payroll ect. Sometimes they get sued , costs go up an insurance disputes payments , and the dentists get screwed up . Imagine your a dentist what would you do ?

Charge up front and skip the bull right ?

Plus you did get the service , you would not expect to walk out of a store with out paying right ?
Reply:aliens frommthe caves claim to be human
Reply:Tell him to piss off and if he doesn't call your insurance company.
Reply:Read through your insurance and speak with your not sure im 13
Reply:Just say no! Find another dentist! Do eat more peanut butter!
Reply:Do not do that...the dentist will get paid twice and you will not get your money back'
Reply:get a new dentist. while researching ask them about their accounting practices.
Reply:That sounds like a dentist that is about to go out of business. My dentist accepts my insurance as payment. Sounds like you need a new dentist.
Reply:Sounds wierd...I would call the insurance company and ask them how they want to handle it.
Reply:I thought there was a small co-payment, and that was it. Certainly not in full. I'm not an insurance expert though.
Reply:find another dentist asap. that's just wrong.
Reply:That sounds strange to me, I can understand if ou had some sort of co-pay for any work done, but full payment up front??? I'd call your insurance provider and make sure that they would even reimburse you before you go back to that dentist.
Reply:i'd call your insurance company........

that is kind of weird........

before services my dentist finds out what the insurance will pay and tells us what we need to bring before the your insurance find out what they will pay and when you will get reimbursed or find out what they expect you to pay and just pay that..........and then find a new dentist
Reply:To me it sounds like your Dentist doesn't trust that your insurance will come through at all. Or he may feel your not credit worthy and wants your payment up front. In either case, he should figure what amount if any you are responsible for, collect that portion only from you and remit the balance to the insurance company and settle the account from insurance. That is how it normally works. Ask your dentist why he can't do it this way. Or if you do have to pay "cash upfront" and no exceptions are allowed then ask him for a 10% discount for a cash transaction. That is customary and it will be worth your while since then you will have to wait for your insurance company to reimburse you. Be sure to follow up with your insurance company for proper reimbursement. Good luck! It will work out.
Reply:tell em to get stuffed and as for the receptionist agreeing to let you walk out well whats she going to do about it she cant exactly stop you from walking out,tell them both they will have to wait til you speak with insurance company and if they dont like it then toooo bad.

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