My dentist’s office is changing billing procedure. I should note that my dentist is not part of an insurance network. It may be a cliché, but I have heard people who say that any dentist who aligns his office with insurance carriers is one you want to avoid. That doesn’t mean that I have to pay the full cost of my visits; my insurance (currently Aetna with COBRA through my former employer) still covers almost all of what my dentist charges for semi-annual maintenance. I haven’t had any problems come up, but the insurance company would cover most of that cost, as well.
As long as I have been a patient of my current dentist, the office calculates what it expects my insurance to cover before I leave the office. They submit the bill to my insurance company, and I pay the estimated remainder. It’s often not much. Occasionally, the estimate is off, and the dentist credits my account or bills me for their underestimation of the insurance company’s reimbursement. This system has worked well, at least for me. It’s less money out of my pocket than if I had to pay the full bill myself and submit the claim to my insurance company after the fact.
Starting with my next visit, approaching within the next few months, this will be the new procedure. The office has decided that rather dealing with the insurance companies directly for payment, this will be the patients’ responsibility. Before leaving the office, I will need to pay the full amount on the bill, and when I get home, I’ll need to submit a claim to my insurance company. I’m not particularly happy about the change.
I’ll need to pay more out of pocket. While the dentist office has claimed that insurance payments come within just a couple weeks, now that payments are going to a patient rather than the dentist, the claims could take longer to process. If there are any disputes, I may have less leverage than a dentist, though I have more motivation to pursue the case. I don’t like the idea that more paperwork will be my responsibility, but it’s always my responsibility to ensure I’m paying no more than I need to.
I was reminded of my dentist’s procedural change by Cameron Huddleston’s article in Kipligner. She received a bill from her doctor that was higher than she expected. She called the office to confirm that the doctor did not submit a claim to her insurance. I would imagine that some patients blindly pay any bill they receive from their doctor’s office, assuming the amount listed is what they owe after the insurance company has already covered part of the bill. It’s good to be aware of the costs of services and to review the bills.
Published or updated July 10, 2011.