I chipped one of my teeth back in 2023 so I went to a dentist to get it fixed, while I was there, I also got my another cavity fixed. And I needed deep cleaning then, so I was planning to do it there as well. But the treatment plan for the deep cleaning was to break it down to 4 appointments, one quadrant per visit, I did not complete the whole treatment because I felt that was a bit much for me.
In terms of the insurance, I knew I had to pay my out of pocket from the get go as there was cavity and I was on my husband’s insurance, so after every visit we paid my share at the front desk, during our last visit, we checked with them before we left, just wanted to make sure we were all good, and they confirmed that.
15 months later I received an outstanding balance email from them. Now the issue is, it’s been so long, I don’t remember everything. By looking at the statement, there is a lot of x ray and photograph charge, and a lot of resin composite too, I genuinely don’t think I received all those things. What should I do? I stopped seeing that dentist because we felt that they were very predatory. I am willing to pay my fair share but I can’t just pay a bill that from so long ago, with all those things that I don’t recall receiving. I need to get to the bottom of this, any suggestions?
My dentist sent me a $1000 bill 15 months after my last appointment
byu/Significant_Fuel9620 inpersonalfinance
Posted by Significant_Fuel9620
11 Comments
I would go in and get a full accounting from them what they did, what you paid, what insurance paid, the insurance discount, what wasn’t paid, why they think you are responsible, and why weren’t you billed in a timely fashion.
Schedule an hour but hopefully it only takes 15 minutes.
Then you’ll be armed with all the info, to decide what the next step is. Which is probably contacting your insurance for a similar conversation.
And now that I think about it, you may want to talk to insurance first, dentist office second.
Most Dentists don’t mean to be predatory, but off on their billing or poor financial tracking. My guess is their book keeping is messed up, so the made up what they thought they needed to do and then started for those. I would go into the office in person with this concern, mention that these items you don’t think you received. They might just write it off. Please note. “Go to the Office in Person”. It gives you more negotiation power.
Resin composite are fillings. X-rays they would take as part of an exam/fillings.
I would ask them for a full detailed invoice showing every charge over the last 24 months, as well as every payment.
How did you pay? CC? You should be able to go back and look through all your statements from that timeframe to determine what all you paid, and compare it to what they send you.
I would check to see if the dentist actually did submit a claim to insurance. I think they usually have 12 months from the date of service to submit an insurance claim, and if they fail to do that, they can’t come after the patient for all of it. Though that may only apply to in network benefits, I’m not certain (was this an in-network dentist?)
even if it turns out it is correct amount and everything I feel like there should be a time limit on these things. 15 months seems way too long.
Assuming you had insurance at the time, and you gave the insurance info to the dentist, and the dentist didn’t tell you they don’t accept that insurance:
They had a contract with the insurance company agreeing to a lot of things, including that they would bill through the insurance company first. You are only responsible for the part of the bill that the insurance company doesnt pay.
They also agreed to only bill agreed-upon amounts for each procedure, even if the insurance company doesnt pay and they are allowed to bill you, it only the amount in their contract.
They also agreed that the insurance company does the math, not the dentist. The official math on who owes what comes in the form of an explanation of benefits (EOB) which is a document the insurance company generates and sends a copy to you.
Also, typically if they didn’t send a bill to the insurance company within one year of the procedure, the contract says they can’t bill the insurance or you.
Tell them you won’t pay any bill until you receive an explanation of benefits from the insurance company. Call the insurance company and ask for an EOB for all work done on dates of service XXX.
If you used dental insurance, go to your account online and see what, if any, claims were submitted. If the claims were submitted and you’re still not sure of your out of pocket, call the insurance company for assistance.
If the dentist is in-network, you may have little to no out of pocket and most insurance companies give the in-network dentist a time limit to submit the claim and if said deadline is missed, the dentist cannot submit claim NOR bill the patient, contractually. Just make sure with the insurance company if this is the case.
If the dentist is out of network, if the claims were submitted and paid by insurance, you might have out of pocket.
It is getting close to summer time and filling up a yacht with gas is not cheap so he probably just wanted to circle back with you and get you to chip in a little more
Check to see if your state has a “timely billing” law. In Texas, they have 11 months from date of service to bill; after that, they can pound sand.
It sounds like he’s just unorganized or she is or whatever if your doctors is a man or woman
I guess my question is $1000 doesn’t sound like a lot of money for what dentist do so I’m not sure they’re trying to screw you over but you can definitely call and ask them to walk you through it
Check your insurance for an explanation of benefits. I had an urgent care visit in August of 2023. They didn’t bill my insurance until last month! With my insurance you have one year to submit a claim. Of course the claim was denied. I received a EOB saying I owe 0. If the provider sends me the bill I’m not paying it.