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    palerider's Avatar
    palerider Posts: 1, Reputation: 1
    New Member
     
    #1

    Jul 2, 2011, 03:18 AM
    Second bill from dentist for payment?
    Are dentists required to accept the payment that insurance sets? For instance I am billed 300.00 I pay 50 up front as co-pay insuance covers 120.00 now I get a bill for 103.00 this math does not add up. How is it set up?
    tickle's Avatar
    tickle Posts: 23,796, Reputation: 2674
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    #2

    Jul 2, 2011, 03:40 AM

    I don't know how it is set up. I don't know your insurance company. Mine pays 75%. My dentist hands me the bill when I am there, I sign that I agree to the charges, they submit it to my insurance company; insurance company pays the dentist their portion, then my dentist bills me the balance. Is this not the case with yours?

    Dentists are not required to accept what the insurance company offers. Why should they for services rendered, take anything less then what they are entitled too.

    Your bill was $300. Did you pay $l50, insurance pays l50. Is that not so? What do you mean you paid 50, you paid 50 dollars?

    Tick
    excon's Avatar
    excon Posts: 21,482, Reputation: 2992
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    #3

    Jul 2, 2011, 05:00 AM

    Hello p:

    The business relationship is between YOU and your Dentist. He can bill you whatever you and he have agreed upon. Your insurance will pay whatever it will based on the agreement you have with them... If it's not enough, then YOU pay the difference.

    excon
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
    Computer Expert and Renaissance Man
     
    #4

    Jul 2, 2011, 06:38 AM

    It depends on the carrier, the contract between the carrier and the dentist and the contract between you and the dentist.

    In some cases a dentist will agree to accept the amount paid by the insurer. In other cases, not. Looks like your dentist doesn't. Double check with the carrier to see if the dentist has agreed to accept the insurance payment. Otherwise you are required to pay. If you have a question on the math, ask the billing department.
    JudyKayTee's Avatar
    JudyKayTee Posts: 46,503, Reputation: 4600
    Uber Member
     
    #5

    Jul 2, 2011, 06:40 AM

    In some cases the Dentist HAS to accept what the policy allows and no more. In others you pay some, the company pays some.

    Companies vary.
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692
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    #6

    Jul 2, 2011, 08:52 AM

    It will depend on the contract your doctor has with the insurance company and the type of policy you have.

    If your insurance company for example, pays 80 percent of the reasonable and customary charge, after you pay a 50 dollar co pay,

    Then you will owe ( at least 20 percent) but if there is not an agreement to discount the rest you will owe it. It is more common in medical insurance for this to be discounted. But with dental insurance it is becoming less common

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