I am in a big problem and need advice. I have premera dental plus plan from Microsoft. Recently I was having a tooth ache and decided to visit a dentist. The insurance covers regular check-up and cleaning at 100%. When I called for an appointment, the receptionist asked for my insurance member ID which I provided. She said she will confirm if the insurance would work. Later she got back saying that it would work and scheduled an appointment for me. In the appointment the dentist suggested deep cleaning, and since that was covered under insurance I decided to go for it. I asked them how much would it cost and they said no need to worry, your insurance will cover it.
Now it turns she is not an 'in-network' dentist, so the insurance company will only cover a part of the bill (~30%). I did not know there was a difference between being 'in-network' and 'accepting insurance'. Shouldn't it have been the doctor's responsibility to inform me that they are not in-network and that this insurance company would not cover the full bill? They did not even give me a break up of costs and specifically said it would be covered by the insurance company. They have now sent me a bill of over 5000$ which is an insane amount. Moreover I am a recent grad from a private university with a huge student loan. I am barely able to make rent at the bay area prices. There is no way I can pay this amount. What should I do in this situation. I am very stressed and can't concentrate on work either :( please advise.
- Amazon FishNChipsThere’s not much you can do. It’s just an expensive lesson for the future. (This happened to me before too, but it was only 1k, not 5k).
- Isn't the doctor at all responsible for this? They specifically said to me that the insurance would cover everything. Either they did not know, which is incredibly hard to believe or they lied through their teeth. Had it been 1k, I would have paid and moved on. But I really can't afford the 5k. After CA taxes and student loan payments, I barely make the rent and food.
- There's no such thing as a deep cleaning? Isnt that just code for scam? Regardless you get an invoice and out of pocket cost estimate before work is done. Did you sign that? If not would say you said insurance would cover so please send me an invoice for 0.
- Always ask if the doc is "in network" vs if the office "accepts" insurance. They can technically "accept" Monopoly money and then bill you after. Sucks so much, I'm sorry it happened to you. You could call the office to see if they can assist with a payment plan and/or reduction of cost due to your experience.
- Apple Berlin007Tell the doctor you owe nothing and you have been cheated.
You were told it will be $0. Threaten them to go to small claims court, also complaint to the dental medical board fir malpractices
Go to a small claims court.
Its not expensive, as others have suggested. Read online the process is simple. $50 for filing and then you need to send then detist a notice, which is nother $100 or ask a friend to do it.
Don’t pay these scumbags
- Planning to buy a house in the next 7 years? If not, just do what everyone else does and simply dont pay it.
They'll charge it off and sell the debt to a 3rd party collector for the amount the bill should have been in the first place. The collector will make token efforts of getting you to pay, but mainly just enough so you remember who to pay when you go to buy a house and the loan officer says you need to clear those collections off your report.
After 4 years (assuming CA) you can't be sued (unlikely anyway) and after 7.5 years, the debt will fall off your report and you're home free.
- They can take legal action and sue you for the money, for up to 4 years after the due date. But there's a very good chance they won't (which means there's also a small chance they will). And yes, it will affect your credit score. There is no free lunch. I mean, if you've got the money, then pay the bill. That's clearly the best choice if you have that option. But if you don't have the money, dont kill yourself trying to pay it. Temporarily bad credit isn't the end of the world.
- Have you tried to call the dentist and negotiate? They can lower the price. I was able to lower by more than 50% for eye and other out network expenses.