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If An employee of a dentist has insurance and the employer files insurance and gives the employee all the money back from the insurance company Is this legal?
Wiki User
∙ 7y ago
No. This would be not only be insurance fraud but would also endanger the license of the dentist involved. Plus if the insurance company ever found out about such a thing, the Dental Practice would have to close down, because no insurance company would contract with someone like that, ever again. If the State Licensing Division didn't revoke the Dentist's license, the insurance carriers no longer processing claims from this business would drive them out of business. The Dentist would have to start working at the 7-11 Store. Crooks are not Professionals.
Wiki User
∙ 7y ago
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If your insurance company requests a refund from your dentist because your insurance cancelled is the dentist required to send the refund?
The only time the dentist is required to refund the insurance company, is after the specific company has already made payment to the dental office and inadvertently was an overpayment for services renderred. In the event that the dentist is a participating provider with the insurance company and has other patients with the same plan, the insurance company reserves the right to deduct the overpayment from any future payments owed to the dental office whether it is for the same patient or not.
For an estimate on dental work should you contact your dentist office or your insurance company?
Contact your dentist office, they will be able to give you an estimate on what you need doing, and then see if your insurance company will cover it. It is possible the dentist office may even be able to tell you if your insurance will cover it over the phone.
I am trying to find a dentist to get rid of a cavity and they won't take my insurance what should i do?
Call the insurance company and ask for the name of a dentist in your area. Alternatively, check the website of the company for a current list of providers.
What is the best company to use for dentist insurance?
The best company to use for dentist insurance is United Healthcare. You can read the list at business.highbeam.com/.../best-rating-notification-dentists-insurance-company - Blue Cross is the insurance company that I use for dental. They are very helpful and pay most of my dental bills as well as prescriptions and special procedures. They are a reputable company and easy to talk to and deal with.
What dentist in killeen tx accepts physicians mutual dental ins?
Either the insurance company has a list or you will have to call each dentist.
Is there an insurance company that covers just dental insurance?
To find a dental insurance you can contact a dentist office to find out what type of insurance they accept. Then contact those companies. If you have a specific dentist office you want to go to then it's especially important to find out what insurance they accept.
Should the Dr's office bill the patient for the Provider Discount that the insurance company gets?
If the dentist is part of the insurance company's network, he or she is contracted NOT to balance bill the patient for the discount negotiated as part of the contract. The dentist can charge for the difference between the discounted rate and what the insurer pays. For example, if the usual charge for the procedure is $100 but the discounted amount is $60 and the insurer pays half; then the dentist can charge you $30. But the dentist should NOT be charging you the $30 PLUS the $40 discounted amount. If this happens you should contact your insurance company as the dentist may be in violation of his or her contract.
What is the definition of doctrine of respondeat superior?
It is a Latin term which means "Let the master speak." In legal proceedings it is the idea that employees are simply agents of the employer, and the employer is accountable for the acts of his employees. Therefore, he must explain, justify, or defend the acts, rather than the employee. Unless it is demonstrated that the employee was deliberately disregarding the directions of the employer, the employer, not the employee, will be held to account for any harm that comes as a result of the acts of the employee. In a dental setting, if a dental assistant were to injure a patient during a procedure, and the assistant and dentist were hauled into court in a lawsuit, the assistant's attorney (yes, the employee should always have their own counsel) would claim "respondeat superior". The assistant was only acting on the direction of the dentist, and therefore it is the dentist that is responsible for the injury. While it may sound like the assistant has just thrown her boss under the bus, in legal terms, she is stating that she was not acting in an irresponsible way, and she was not free to ignore the direction of the dentist. The dentist, with his greater training and knowledge, is in a much better position to describe what happened and explain why it was not malpractice.
Where can you get insurance that covers invisalign?
You'll probably have to call the claims department of each company or check with your dentist.
What can you do if your employer is changing dental plans and it is not accepted by your current dentist that is doing major dental work?
== == Your old plan should cover work started or you should request grace period from your employer, Contact insurance comapny and/or employer. To find companies in your state that provide dental insurance or dental discount plans, go to the National Association of Dental Plans site (www.nadp.org) which has a directory of companies that offer dental insurance. The directory can be searched by state and you can select "individual" and get the list of just those companies that provide individual dental insurance in your state. The listing also tells you if the company provides dental HMO, dental PPO, dental indemnity (traditional insurance without a network) or a discount plan (not insurance but a discount off the dentist's fees who are part of the discount network).
What is the average cost to get tooth bonding done from the dentist?
It depends on the insurance company, how much they cover, and the company that is willing to fix it.
Who's responsible if the dentist neglected to file the claim?
Sorry if this is not what you want to hear, but you, as the patient, are still responsible for the charges. Most (but not all) insurance company will process the claim if it is made within one year of services. Get a copy of the charges from the dentist, and make sure they include the current ADA codes. Call your insurance company and ask about the claim. It is YOU the insurance has to to, since you are the covered party. (And who pays the premiums, either yourself or through an employer). The dental office only files insurance claims as a courtesy. Too many times the insurance company will tell you that a claim was never received, when in actuality it is on somebody's desk or garbage can. Regardless of that, it is still your responsibility to make sure your services were paid for. If you have a claim that has not been filed by the dentist you first check with your insurance carrier to see if it has been received. I work with insurance companies and they are not allowed to trash or leave any claims lying around or they will be fined. There is a certain law called HIPPA that could get them in a lot of trouble. If they say that it has not been received, yes you can get the information from your dentist to file the claim. If the dentist is in your network under your insurance plan 9 chances out of 10 they have a contract with the insurance carrier to file the enrolee's claim. The reason for that contract is that when payment is made that payment will go to that contracted dentist regardless if you paid in full or not. Also, being that the insurance carrier has a contract with this dentist, have the insurance carrier contact the dentist office to see what has happen. I do it everyday. : As the previous two s clearly stated - the responsibility falls on the insured to follow up on claims for work they had performed. Even if the office failed or neglected to file a timely claim - balance is still your responsibility. As a person who deals with insurance on a daily basis i can appreciate the patients that care about their claims and give me a hand in getting them processed. We file insurance as a courtesy to our patients not because we are mandated or required in any way by the insurance company.
