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LiveItUp
Love my babies!
Member since 8/11 4096 total posts
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Just found out my dentist is no longer part of my insurance network AFTER my appointment. ~UPDATE~
I don't understand! I just got a letter from my health insurance company saying the dentist I saw a couple weeks ago (who I've been going to for years) is no longer a part of the network so the insurance company didn't pay anything towards the billed amount of $300   and it said that the dentist may bill me.
What I don't get is why didn't the receptionist and/or dentist say something when I went BEFORE being seen by the dentist? Wouldn't they know if they no longer participate with that insurance (GHI)? Or is it my responsibility to check with GHI every single time I ever see a dr. or dentist just in case they are no longer covered???
I'm especially annoyed because I only went to see the dentist about a pain I was feeling (which turned out to be nothing) but while I was there she said I hadn't been in over a year so I should get a examination, xrays, and cleaning "since those are covered by my insurance once a year" so I let her. I wouldn't have had I known I would end up having to pay for them! 
UPDATE: so I just called the insurance company and they said that after they mailed me the first letter saying they wouldn't pay anyting, that they decided to mail me a check for $84 (which must still be in the mail) even though the dentist is out of network that I'm supposed to send to the dentist. So that's something, I guess. Then I called the dentist office and the receptionist said they ARE a part of the network  and that I shouldn't get a bill??? OK, I guess I'll wait and see what happens.
Message edited 1/4/2012 11:52:10 AM.
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Posted 1/3/12 7:40 PM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
Mrs213
????????
Member since 2/09 18986 total posts
Name:
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
I think they should have let you know
That's a big deal
I often see signs in dr. offices that say "sorry we no longer accept xxxx insurance"
I would just call and make sure it's not an error first but the I would give them hell for it
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| Posted 1/3/12 10:16 PM |
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cateyemm
Twins!
Member since 7/10 8027 total posts
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
It's happened to me. twice. with two different dentists. ultimately, it's your responsibility to ask the doctor "are you in network with so and so?" before every appointment. i dont really know how it works, i thought dentists have to preauthorize each appointment, but maybe not.
in my cases, the first time, the secretary made an error and the second time, the DENTIST made the error but i ended up having to pay anyway. you should speak with the dentist to get him to waive the fee or at least reduce the rate.
eta- my advice is to actually check your network, not even to ask the dentist if they're in network because that's exactly what i did, and i still got screwwed.
Message edited 1/3/2012 10:38:32 PM.
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| Posted 1/3/12 10:37 PM |
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MrsS1976
LIF Adolescent
Member since 5/11 534 total posts
Name:
M
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
This happened to my husband a few months ago. He has a regular dentist and his dentist switched out of his HMO and failed to tell him.
He went to his appointment as usual and then underwent additional work at a lab.
He gets the bill 3 weeks later for $ 500. He was SO ANGRY - he immediately called the dentists' office and yelled at them, and the very next day went over there in person and demanded that they pay his bill. The dentist actually ended up paying the entire bill including the Lab fee.
So go in person and raise HE.LL. - because they had a duty to tell you about the insurance switch!
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| Posted 1/3/12 10:45 PM |
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Diane
Hope is Contagious....catch it
Member since 5/05 30683 total posts
Name:
D
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
write a letter to the dentist. I had this happen to me with a dr. and he let of the bill. I also called the insurance company as well. that is NOT right. The dentist receptionist should have let you know. I would fight it!!!
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| Posted 1/4/12 8:03 AM |
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ali120206
2 Boys
Member since 7/06 17792 total posts
Name:
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
Does your insurance cover preventative treatments (cleanings)? Many do - both in and out of network - since it saves them $$ in the long run.
Check and see if the submission was coded right when it was sent to the insurance company as well.
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| Posted 1/4/12 8:23 AM |
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Chai77
Brighter days ahead
Member since 4/07 7364 total posts
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
I'm sorry to say that I believe it is ultimately the patient's responsibility to confirm coverage and benefits. If the office knew, they should have had the courtesy to tell you, but if they didn't I think you are still unfortunately responsible for the bill.
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| Posted 1/4/12 8:25 AM |
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Xelindrya
Mommy's little YouTube Star!
Member since 8/05 14470 total posts
Name:
Veronica
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
Posted by Chai77
I'm sorry to say that I believe it is ultimately the patient's responsibility to confirm coverage and benefits. If the office knew, they should have had the courtesy to tell you, but if they didn't I think you are still unfortunately responsible for the bill.
yeah.. sorry but I have to agree with this. However that said, I'm sure the dentist may be able to help with the cost.
Another thread sort of implied the same thing. Always check each and every time. Even the Insurance company's website isn't always 100% updated. It has a disclaimer on it as well.
Rule of thumb is anything over $300 should be cleared first. I keep to that on everything. I had an appt to pull a tooth and I refused to go until they could PROVE to me it was covered, two months later (after my scheduled appt) and its going to cost ME $1500 so I haven't done it.
I won't do lab work, blood draw to CT Scan, without preapproval. I will ask when making an appt to be sure they are still participating in my plan then ask again when I get there. Id rather waste time than money.
Even Dental Xrays I learned are usually done on a different day.
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| Posted 1/4/12 10:22 AM |
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TwoGirls4Me
Treasure what you have
Member since 5/05 1839 total posts
Name:
Marie
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Re: Just found out my dentist is no longer part of my insurance network AFTER my appointment
Posted by Chai77
I'm sorry to say that I believe it is ultimately the patient's responsibility to confirm coverage and benefits. If the office knew, they should have had the courtesy to tell you, but if they didn't I think you are still unfortunately responsible for the bill.
This. As a courtesy they definitely shouldve let you know but ultimately it is the patient's responsibility. I would call and speak with the office manager, they may be willing to only charge you what your insurance would have paid, or offer some sort of a discount on the bill. is it an HMO where there are no out of network benefits?
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| Posted 1/4/12 11:41 AM |
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