I received 2 statements in the mail from our dentist. One for DD and one for myself. DD's said I owed a balance of $36, for her recent cleaning, fluoride and sealants. At first I was like "oh, that's not too bad". Then I was like "WAIT A MINUTE! Cleanings are supposed to be covered 100%....". Then I open my bill - I was expecting a bill of about $500...my 50% share of the crown and the bill is $662. By then I'm about freaking out. Of course it's Sunday when I picked up the mail, so I can't call the dental office.
At first I thought the extra on my bill was that they didn't get the claim resubmitted from my initial visit, when the tooth first broke and they had to do the temporary buildup. I had paid a 50% estimate at the time and then they tried to bill me another $96. In looking at my insurance EOB I discovered the insurance company had denied processing a portion of the claim until they had "more information/narrative" from the dentist office. I faxed the dental office a copy of the bill along with the insurance eob and said I wasn't paying anything more until they supplied the insurance what they needed to finish processing the claim (this was back in June).
So, I got online with my dental insurance and printed out the EOB's for our visits. Well, first issue is the dentist is not showing as a participating provider, so they are not paying at full benefits. Second issue is DD's EOB specifically showed a provider w/o of $10 and the dentist office didn't write it off, they added it to the bill. On my EOB the total billed was $1025, but the allowed amount was $747, but nothing was shown in the provider w/o (I'm thinking because it's a non participating provider).
Monday morning I called the dentist office and first thing I said was I think we have a problem in that you are no longer contracted with my dental insurance? Apparently the office was sold to a new dentist a few months ago and they are still working on getting everyone credentialed and contracted, but they will be and their corporate office is supposed to process the claims payments as if they were contracted. They were also supposed to write off the disallowed amount, not bill me for it. It's a good thing I am very familiar with reading eob's (past job) and knew something was messed up. I wonder how many people have just paid them the past few months, not realizing they were not supposed to be billed.
Every dental claim we've had in the past (even my root canal) didn't have much of a provider write off at all, so I was not expecting this big of one ($278) for my crown. Instead of the $512.50 I was expecting to owe I now only owed $373.50! I had her charge it to my CareCredit card and I was also given 12 months no interest on that.
This CareCredit account has been a godsend this past few months with the vet and dental bills. I first put the big vet bill of $466.02 on it. Then my portion of the root canal of $291.80 and now the $373.50 for the crown. The root canal was only a 6 months deferred interest (due to the lower amount), while the other 2 charges are 12 months deferred interest. I have my payments set up to have each paid off by the time the promotional period ends. My total monthly payment is $119.25, but $48/mo of that will be paid off in 4 more payments. No interest and it's helping rebuild my credit - double win.