More frequently than not, dental insurance per se is not an indemnity policy; in that sense it differs from a major medical policy in the way that it functions. Instead, it pays a fixed sum for stated services by a dentist who participates in its plan.
However, in situations where, for example, reconstructive surgery is medically necessary due to an occurrence, and implants are a part of the reconstruction, a major medical policy may pay for the implants. Naturally, any payment would be subject to the terms and conditions of the policy, including deductibles and copayments.
It depends on what area you are in. Call wellcare and give them your zip code they will give you a few names and numbers in your area. You may have to travel to destinations that are far. If you are in the area of Georgia : Medical College of Georgia offer it but you have to be on a waiting list.
== == 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). The term "plans" is sometimes used to refer to the companies that offer dental benefit products. There are four basic dental benefit products: dental HMOs, dental PPOs, dental Indemnity (traditional insurance with no network) and discount dental (not insurance but you get a discount on the fees charged by participating dentists). DHMOs, DPPOs, and Dental Indemnity products are "insurance. The National Association of Dental Plans site has a directory of companies that offer dental insurance that can be searched by state. You can select "individual" and get the list of just those companies that provide individual dental insurance or discount plans 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. As of mid 2007 there are only 22 dental plans that provide individual dental benefit products across the nation and they do not all operate in all states. The number is increasing daily. Here are opinions and answers from FAQ Farmers: * I have found unicare offers a PPO plan for individuals. I am about to take out the plan on my child. I had been going back and forth on this for over a year. This is the only one I have found. And my sons dentist is in the plan. * Ameritras offers a dental PPO plan for family and individuals. * In reviewing this answer's history, it appears that some of the information you've been given pertains to a dental PLAN rather than dental INSURANCE. In my own attempt to find individual/family dental insurance, I found a plethora of DENTAL PLANS, but I was could not find any individual DENTAL INSURANCE. Further, there isn't an insurance broker or provider named Ameritas; there is, however, the Ameritas Insurance Corporation, but they only provide dental insurance plans for groups. I found this helpful information at the American Dental Association's website. Even on the ADA's website, the difference between the terms "dental plan" and "dental insurance" are not clearly stated. "What is dental insurance for individuals? Dental plan coverage for individuals is not commonly offered because dental needs are highly predictable. For example, you would not pay premiums for your dental coverage if the premiums were more expensive than the cost of the dental treatment you need. Since this is the case, insurance companies would stand to lose money (spend more on benefits than they receive in premiums) on every individual dental plan they write. There are, however, a few companies that offer a form of dental benefits for individuals. Most of these plans are "referral plans" or "buyers' clubs." Under these types of plans, an individual pays a monthly fee to a third party in return for access to a list of dentists who have agreed to a reduced fee schedule. Payment for treatment is made from the patient directly to the dentist. The third party acts only in the capacity of matching the individual to the dentist. The dentist receives no payment from the third party other than in the form of referral of patients. are differences between a dental PLAN AND dental INSURANCE." You see, the question asked was about dental INSURANCE. The answer, however, immediately refers to a dental "plan", as if it was synonymous with dental insurance! But then, in the second paragraph, it describes "referral plans" and "buyers' clubs"....more commonly known as DENTAL PLANS, not DENTAL INSURANCE! I found a website that explains the difference between plan/insurance much more clearly. I listed it in the "links" - but in case I did it incorrectly, just go to dental-resources.com and in the left frame, underneath the heading Financial (look for the Ben Franklin!), click on "dental insurance plans". There's also a link if you need to know about financing. *Note that it's a commercial site, not affiliated with the ADA. Also, I'm not affiliated in ANY way with this site or the ADA or anything DENTIST, period! (just in case) "Dental Insurance Plans & Programs Dental health is extremely important for individuals and families and it's financially helpful to have some form of dental coverage to minimize the costs of dental care. There is a difference between traditional dental insurance plans and discount plans. Let's first start out talking about dental insurance. It's typically only available to individuals and families who receive their dental insurance coverage through large groups or through their employers. There is a premium that the employer pays to have their employees dental care covered. So how does a Discount dental plan differ from a traditional dental insurance plan? A dental plan is very similar to holding a membership in a buying club? You pay a flat fee yearly. These gives you access to the provider dentists. The discount dental plan negotiates a discounted rate for typical services like hygiene visits, exams, fillings, cleanings, root canals, orthodontics, crowns etc with the provider dentists. The dentists agree to provide these services to you at the pre-arranged discount rates which are often displayed prior to purchasing the reduced fee plan. They are ideal for individuals and their families who do not get dental insurance coverage through their employer. There are substantial savings that can be obtained through the provider networks in the range of 10 60 %. The one drawback can be the limitation of only being able to visit a provider dentist. However even traditional dental insurance can have similar limitations." Some of the PLANS are pretty good, and can save you quite a bit of money. Our dentist is great, we found a plan she accepts and we get a decent discount on all services. Payment is expected up front! We had to get financing (it's like a dental credit card that you apply for) - ask your dentist about it. * Actually Ameritas does offer ppo dental plans but as someone else suggested, through groups only. However, there are groups you can join that offer these types of benefits. Be careful as some offer insurance products and some offer only discounts. We chose and bought the Valu+ plan. It currently (Aug 2006) costs $69/month for the whole family. It has Ameritas Dental, VSP vision, Liberty Medical discount diabetes supplies (my daughter is diabetic), an AD&D plan and an accident supplemental. I think I paid a one time fee of $30 to join the group but well worth it for my family. I was paying well over $100/month for dental alone.
That is a matter for your own conscience to decide. Unfortunately there MANY decisions in life that involve this condundrum. No one can counsel you on your own beliefs, morals, or personal code of ethics.
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).
* I don't believe so but I don't know of one that has such an extensive network that they are sure to include dentist near you. I know lots of problems with that is the referral process for specialists. == == * They are becoming scarce. It is usually because once you weigh the cost of the premiums verses the amount you receive in benefits, it's a no-brainer. For example: you purchase an individual policy that allows you to go to ANY dentist you choose-no networks, no HMO, no PPO,no restrictions at all-and you pay $150 per month in premiums. The policy pays 100% preventative, 80% for fillings and such, and 50% on big stuff like crowns. The annual maximum they'll pay for any and all treatment is $1500 (industry standard). If you look, you're paying $1800 per year for $1500 annual benefit. Just doesn't make financial sense to be doing that. Most insurance companies know that John Q. Public has wised up to the limitations and aren't offering those individual type of plans much more. So if you do find a plan, make sure to watch for limitations in the policy like the maximums, as well as any limits on "pre-existing conditions" or whatever else is in the fine print. == == * I have to agree that very often dental insurance is more expensive than the benefit. That said, I found a good solution that I find cost effective AND it does include benefits for out of network dentists. * I chose a bundled package of benefits that includes Ameritas Dental, VSP Vision, Liberty Medical (diabetic supplies), an Rx plan, and Accident supplemental & an AD&D. The whole package is only $69/month for the whole family and the dental benefit is up to $1000/year/person. The have a network benefit as well as a schedule of benefits for out of network dentists but it is generally less. * I found the combination of benefits and price a great combination. It is not available in all state but most.
I think I remember Qualified Health (another discount card) having one provider in Anchorage, AK. But QH is much more expensive than Ameriplan (AP) (e.g., QH $4 a day for a family, compared with AP $19.95 a month per HOUSEHOLD-which is awesome with the huge variety of 'living' arrangements nowadays). Advantage Dental
AIG American General Insurance
American Dental Professional Services
Ameritas Life Insurance Corp.
Assurant Employee Benefits
CIGNA Dental & Vision Care
Citizens Security Life Insurance Company
Delta Dental of CA, NY, PA & Affiliates
Dominion Dental Services, Inc.
First Dental Health
Guardian Life Insurance Co. of America, Inc.
HumanaDental Insurance Company
Liberty Dental Plan of California, Inc.
Lincoln Financial Group (formerly Jefferson Pilot)
Morgan-White Administrators, Inc.
National Guardian Life Insurance Co.
Premera Blue Cross
Principal Financial Group
Security Life Insurance Company of America
Shenandoah Life Ins Co
The Dental Care Plus Group
Trustmark Life Insurance Company
United Concordia Companies, Inc.
Venture Health Group
Wellpoint Dental Services
I just signed my father up for the dental plan through AARP. It's ~ $550 a year for insurance coverage but it's a good plan. www.aarp.com AARP is good. Also, many of the companies that offer Medicare Supplements also offer Senior Dental Plans. Here in California Blue Cross has a good plan. 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).
I have medical and dental insurance, but I do not have rx insurance. If you don't have rx insurance you have to pay for all your medicines. I haven't seen where dental insurance pays for medicines. Usually only rx insurance will
The coverage that is provided by them is not worth the cost and the aggravation in the long run. It takes them forever to pay a claim and when they do pay it such a meager amount that if a person saved their money that is paid for their so called coverage the cost would be the same or maybe less depending on the dental work done.
Another fault with their "coverage" is that if you have anything done while paying the premium payments and have the claim filed by the dental office during this period, and you want to cancel approx. two months later, their affiliate ameritas group will deny payment claiming that the policy was canceled and claim was paid after cancelling. This is due to their shoddy and foot dragging in making claim payments to the provider in a timely manner. You are then told to return the payment in full, which is typical of deliberate slowness in claim payment by insurance company, because when the dental work was done you were covered and up to date.
For families of the United States, there is a dental plan specially for you. The plan is flexible and provides a wide coverage area than other plans, since it is designed to meet your needs. My braces cost me only $2000 rather than the national average of over $4000 because of the information on the blog. There are Thousands of dentists and doctors that are providers under this great plan, and they are closer to you in terms of location. Affordable without sacrificing coverage and services is what every family is searching for.
I also was in need of some type of coverage for braces because I believed my insurance did not cover enough. After months I found the perfect plan. Braces usually cost around $5000. I paid only $2200 for my braces because of this great plan I have.
You can choose a Dental Plan that covers Braces. 60% off Orthodontics, includes Cosmetic and Specialists. Free vision, Rx, and Chiropractic Care. Under $20/month for the entire household, related or not!Affording bracesYou could purchase more dental insurance, but be careful. You may end up paying more in the long run than if you just borrowed the money. A large number of Orthodontists now offer no interest plans for up to a year, and extended plans for up to 5 years. It's helped many of our patients afford the care they need.
A bit more:
Dental schools often offer extremely low prices on all sorts of dental services. The dental interns work pretty much as M.D. interns do, working under the supervision of experienced doctors to obtain experience, while at the same time providing quality care for patients. Dental colleges offer the same quality of services, just not in hospitals where M.D. interns do their residency.
So I would advise you to check with local dental colleges to see what kind of services they offer. You just may be pleasantly surprised.
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.
You may be able to. Your dentist must take both your dental insurance and your dental discount plan.
Here is an article on it...
Root canal therapy or extraction. Infected teeth can never get better on their own.
There are various assistance programs that vary from state to state, so you may want to contact your state dental society to see if there are programs in your area.
Another possible source of lower-cost dental care is a dental school clinic. Generally, dental costs in school clinics are reduced and may include only partial payment for professional services covering the cost of materials and equipment. Your state dental society can tell you if there is a dental school clinic in your area.
Locate individual state health assistance programs - See the Related Link belowAnswerLook into state assistance. They have coverage for unemployed people, most of the time. If you have the money to pay for the dentist, a lot of dentist will see you if you pay cash. AnswerEvery person has a heart. If you are unemployed and you ain't got a medicard, just have enough humility to go to a dental office and ask the senior dentist if she could treat you for no professional fee. Maybe some will say no....but there will always be one who will accept your plea.
You can find information at:
FIND A DENTAL PLAN Directory Onlne - a list of NADP members that provide dental benefits plans in your state, for information on coverage, links to their websites and phone numbers. The National Association of Insurance Commissioners (NAIC) (insureuonline.org) is the organization of insurance regulators from the 50 states, the District of Columbia and U.S. territories Insurance Resources at The American Dental Association (ada.org) - many state dental associations sponsor or endorse programs for their members. Web based insurance quote services are available that allow you to obtain a rate quotation on-line or by e-mail. Refer to links below
It depends on the insurance. Your dentists office can call and check on it for you. Or when you sign up for it ask if it does. Most common insurance coverage for dentures is at least 50%. I believe that it should although all may not but i know a plan that would cover all preexisting conditions as well as dentures.
I am a practicing dentist in Missouri.
I strongly feel that due to the many missed appointments that my office has, I must charge a fee for missed and no show appointments.
We treat adult patients, and we explain the importance of keeping appointments to them. In answer to ones conclusion that dentists should suck it up and count it a business expense, let me say that we annually raise fees due to all the business overhead expenses looked at as a whole.
I do not feel that it is fair to charge everyone for the mistakes of a few. And neither would any of you want to see increased charges just because a few will not keep their obligations.
All I have to sell is my time, we are not like Wal-Mart where any and all can come in any time and stand in line until they are served. If we did not reserve appointment time there would only be chaos and no one would be happy.
In answer to the point that a doctor should pay the patient, I disagree, if truly the doctor and his staff are trying to seat and see patients promptly. I would agree that if the doctor did not have a good excuse then there are grounds for charging, but as a dentist I never intentionally keep my patients from being seen on time.
We allow our patients to give us a good excuse and will forgive the first time that it happens. But when patients don't call so that we can fill the slot, then a fee is necessary. I am always hoping that I can turn people's patterns around so that we can have a professional relationship in the future.
If you didn't sign anything on your first visit, then I don't believe they can make you pay. If they refuse to see you unless you pay, you should go to another office. A lot of dentist offices have a policy that they charge you for missed appointments, but they have you sign a paper agreeing to this at your first visit. Tell them you refuse to pay because you never agreed to this. Then leave and get a new dentist if they still want you to pay.
Legally they can not bill you as far as reporting to creditors, but they can bill you internally, because the appointment you missed could of been for another paying customer.
Obviously they can as I have missed 2 appointments unintentionally and have paid an exhorbitant amount of Â£15 pounds per missed appointment before they see me again!
What appalls me is that the fine charged is an amount that is even more than what you pay for some dental treatments!
As an adult I find that a fine imposed on someone who has missed an appointment for genuine reasons is unnecessary. No one wants to see a dentist unless the have to. So why penalize us when we know that by making that dreadful appointment we are going to pay for it in more ways than one?
The biggest form of payment being the trauma of pain, fear and vulnerability of sitting on a dentist-chair exposed to the dentist's invasive tools. Then, having to pay for treatment when you already have to cough up thousands of pounds per year personally for "National Insurance"! And now, paying for a missed appointment which we did not intend to miss!
The missed 15 minute appointment incurs a charge of Â£15 at a rate of a pound per minute! One would think that this mere 15 minutes could easily have been absorbed into their already crammed workday. Perhaps to spend more quality time on the patients that they have squeezed into their working day at a ratio of maximum quota of patients seen to hours worked!
In answer, "Yes" they can charge us for missed appointments, but, they really don't have to.
I believe anyone who has missed an appointment should pay. They have wasted the time of the practitioner, time which could have been offered to another patient. I am a podiatrist and I get at least 200 patients a year miss their appointment. This equates to over Â£4000 in lost revenue.
I always charge a fee for a failed attendance and have successfully claimed money through small claims court if people refuse to pay.
We own a dental office and we loose so much money due to people who miss their appointments. Honestly, we would prefer not to have these people as patients. We do charge if less than 24 hours notice is giving for the cancellation or if the appointment is missed. It is very irresponsible and disrespectful for the doctor, the staff and other patients who would have wanted that slot.
I believe a dentist office should charge patients for their missed/failed appointments or cancellations without a 24 hour notice. In the case the patient is scheduled with his hygienist, he must pay the hygienist whether she has a patient in the chair or not. In our office here in California, USA the dentist pays the hygienist $50.00 per patient. Every patient that fails to show up or calls to cancel not giving the office enough time to see if they can find someone else to come in at that time should indeed be charged. It's time that patients treat physicians with some respect. If you failed to pick up your child at daycare on time you would pay the penalty. If you failed to pay your Visa on time you would pay a penalty. If you parked your car and the meter ran out and you were ticketed, you would pay the penalty. Your lawyer will charge you for your time. Your hairdresser should as anyone trying to run a business. There is a huge overhead to pay while the office sits idle. More than that. Be courteous and respectful of others time.
Happened twice in the last 5 years. The first time I said screw it and moved on to another dentist, the second time I kicked up a fuss and they backed off. A 20min check up costs ?60 - that's for an x-ray, a quick prod and brush. If any work needs done that's another ?60 - 100 at least.
When we opened our office in 2001, we did not initially charge for missed appointments. After 2 years of patients being so disrespectful and not showing for appointments we do charge $50 for a no show or late cancel. A new patient fills out paperwork and like with any contract, it clearly states that they understand that if they do not give the required 3 business days notice there will be a charge of $50. My doctors and hygienists are extremely punctual as we do not wish to be disrespectful of our patients. If a patient has to wait 5 minutes once they arrive that is a long time. We call our patients who have upcoming appointments 30 days prior to the appointed date to allow them ample time to make other arrangements. We call again 2 weeks before the appointment, 5 days before the appointment and again 24 hours before the appointment. It takes a long time to make these calls but we find it is worth it in the long run because we usually see about 200 patients per week and have approximately 10 no shows or late cancels out of that number.
I understand the rationale as expressed by several dentists here but there seems to be one-sided viewpoint here. I would be happy to agree to pay some predetermined fee should I miss an appointment and not provide the agreed upon notice IF I am also going to be paid for my time sitting in a waiting room because of over booking or poor appointment management.
I fully understand that a dentist?s time is money, so is the time of the patients. Shouldn't this work both ways?
It seems missed appointment fees are here to stay, but it is unfortunate that Doctor's offices have chosen to be cowards in business. Missed appointments are a part of business. That's life. You lose some and you win more. You don't win them all. Missed appointment fees are an attempt to win them all. All the complaining about opportunity costs associated with appointments I am sure are real. Oh well. Stand up and take the loss like a real business.
Like any business, dentists find it necessary to pass the expense of missed appointments onto their patients. Some choose to pass it directly on to those who are responsible with missed appointment fees while others choose to pass it on to all their patients through overall increased fees. When you miss an appointment, it just as though you reached into the dentist's pocket and took money out of it. It is simple as that.
Think of your dentist's office as a scheduled airline flight. When you have an appointment, a seat on that flight is reserved exclusively for you. The flight is going to take off on schedule whether you are on board or not. If you missed your flight, you are not entitled to a refund of your ticket, because the plane took off and incurred the expense without you.
If you prefer to be a patient in a practice where they apparently don't care if you show for appointments, just call around. If you look hard enough, you might find an office that is willing to accommodate you.ANSWERThat lying dentist failed to mention he double and triple books all his appointments anyway.
I spent around $7500 for dental care at a dentist's office and never missed the appointments during that time. Most of my issues were resolved and I was given an appointment several months in the future for follow up of gingivitis care and cleaning. I missed the reminder call and the appointment. Did I get a call asking if I was OK or to reschedule my appointment because the dentist thought I needed to be seen? No, instead I got a $50 bill for missing an appointment. I was charged for not receiving any services. Now, is that a professional caring dentist? The next thing I received a was statement reviewing my insurance and how I needed to to make an appointment so their office could charge as much as possible on my insurance before the year ended. Dentists make more than physicians because their rates are not regulated by medicare and yet all I hear from dentists is how time is money and that their sorry no-show patients are showing them disrespect and are not professional. And you idiot business owners who side with them need to understand: If a dentist loses money on a no show, that is not going to shut down the dental office because they can't pay their overhead. It only means that the dentist has to settle for a Jaguar instead of a Ferrari.
I can answer this question. The answer is yes. Whiplash can cause your to clentch down on your teeth causing an impact. This impact can be uniformed and thus the damage teeth caused by the concussion injury may not be symptomatic for years (usually within two years). The injury causes an inflammation (chronic) response and will slowly destroy the vascular bed of the pulp and then the injure tooth or teeth dies. I have seen damage of this type extend to many teeth up to 28 teeth. The accident may even be a minor care accident. Remember, humans are 90% water. Any impact is a serious multiplication of forces. Check your high school physics text. Martial artist rely on impact to stop an opponent. Impact forces are measured to be so high that it may be beyond believe. Whiplash can cause injury similar to a kick or a punch to the chin called "an upper cut" in boxing. I have been researching this subject for the last two years and I presently hold a degree in Dentistry and Medical Sciences.
You'll probably have to call the claims department of each company or check with your dentist.
In theory, yes. Most offices can give you an "estimate" of expense, but to know exactly what your insurance plan will pay is difficult. The problem is each insurance plan is different for almost every patient. We can submit a pre-estimate form for the insurance company, but it takes almost 4 weeks for a response. The best course of action: Ask the provider for the fee and dental code# for the procedure- call your insurance company yourself. Remember: They may say they'll pay 80% - but be sure to ask "80% of their fee or 80% of what you allow"? They're often very different numbers.
The medical expenses are extraordinarily high in India and a comprehensive insurance policy is the best way to tackle the problem of rising price. As a result of the assorted means of advertising, you're currently quite aware of the numerous health insurers in operation in India. For Compare Health Insurance :
You may still excede your limit, but you shouldn't have to pay out of pocket. The insurane that is in your name is billed first. Then anything that they don't pay, the other insurance will pay. If one of them runs out on the limit, the other one will pay what they would normally pay and you will be left with what is not covered. But there is now way to combine the two yearly limits to make a bigger limit.
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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