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What do you do if a dentist charges you an 'insurance filing fee' but your dental insurance contract says they can't?


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Answered 2006-02-26 16:29:50

Show the dentist in your contract where it says they can't. If it solves it, great. If not, you need to call and talk to your insurance and see what they say for you to do. You may need to find another dentist if it becomes too much of a hassle or talk to a lawyer. Whichever you choose. Dont pay your dentist, tell him or her to take it up with the insurance companie. Bring your contract in to your dentist. It may be an honest mistake. With SO MANY different policies out there, no dental staff can know and remember them all. If your claim isn't paid in a timely manner, and your dentist does have to re-file with the insurance company, call your insurer and get on their case! The insurance company sure wants their premiums on time, so you should expect them to pay your dental claims on time. Unless the dentist is a preferred provider for your insurance company, they can charge a fee. It doesn't make any difference what your insurance contract says. If you have gone to a doctor out of network, you have no recourse. To use your dental insurance in your best interest, you must go to a preferred provider. A preferred provider is someone who has signed a contract with a specific insurance company indicating they will follow the "rules" of that company and accept the fee schedule. If your dentist has charged for a insurance filing fee, notify the insurance carrier. It is written in the dentist contract with the carrier that fees for filing claims should be not be charged. Get a rep from the insurance company to call and notify the doctor if they are participating in your plan. Alot of the time the office staff can not remember all of the policies. If there is a timely filing deadline on the plan and the insurance company has told you that it has not been received see if they can provide you with a fax number. If the timely filing deadline has expired and the dentist can provide proof that they have filed the claim several time the insurance carrier can accept that and will process the claim when received. If the provider can not show proof that the claim has been filed during the timley filing period normally the insurance carrier does not hold the patient responsible for the charge. Especially if the dentist is a participating provider. Please read you explaination of benefits. It states it there or contact you ins carrier.

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