Hubby Tony and I go to the same dental office, staffed by two older men who had
practiced together for decades. Late last year one of them announced his
retirement, and the other quickly followed. The practice was sold to a man who
had only been out of dental school for a few years. I called the office to
inquire about insurance after the change. The person I spoke with told me that
the new dentist was allowed to continue under the previous contract. She did not
offer any other details.
At my fall cleaning I briefly met the new dentist when he came in to check my
teeth after the hygienist finished her cleaning. On the way out of the office
I made a six month appointment. Eventually the insurance Explanation of
Benefits appeared, showing everything was paid.
In mid-March it was time for another six month appointment. I showed up at the
office, checked in at the front desk, had a set of x-rays and a nice cleaning,
then stopped by the office again on my way out. It wasn't until then that I
learned that as of the first of the year the practice was no longer in-network
for the dental insurance both Tony and I have.
The main reason Tony and I have insurance is to minimize the out of pocket
costs! Our plan covers the complete cost of the biannual cleaning and check
up. I told the billing person I thought it seemed reasonable to expect them to
notify us when the provider's in-network status changed.
She could not answer my question about why they hadn't contacted us in the two
and a half months since the year started to give us the news, or why she
hadn't talked to me before I went back to the treatment area. All I got was an
apology, and an offer to give me information about a discount plan they
offered.
I told her I was not happy, and would be starting the process of finding
a new dentist. She did not have a response.
Several weeks later the EOB I received showed the insurance (as I suspected)
only paid a small portion of the bill. I composed a letter to the practice
outlining my concerns and letting them know I expected them to waive the rest of
the balance.
I haven't received a response. I suspect I won't get one.
Five years ago today:
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Consider Physician Mutual dental; (it's for everyone, not just physicians; it's advertised on TV.) My Mom had it, and after my dentist retired, and the practice was bought by a drill happy guy, and to other dentists that moved too, or were too happy to do unnecessary stuff, plus switch and baited me, I got the Physicians Mutual plan. Helps a lot. Also, if there's a community college dental hygiene school in your county, it's a wonderful deal. At Johnson County CC, they charge $10, for everything but pulling teeth. You have to loan them your mouth for about 3 hours, so the students and teachers and the overseeing dentist can decide what to do, then the work is done and checked. I even had some scaling done for $10. But you have to live in the county and see them during the fall and spring semesters: no weekends or summer visits. Linda in Kansas
ReplyDeleteSome great suggestions here. However, since we have no relationship with this new dentist we'll just find one who IS in-network for our dental insurance.
DeleteI hate when things like this happen. You should have been informed. If they don't respond to your complaint you are better off moving on. Well they don't cover your insurance anyway.
ReplyDeleteHow annoying about the insurance mixup. I hope you get things fixed in your favor.
ReplyDeleteAh yes, we've been through this. The practice sold to young, brilliant dentists, who have lots of debt and cannot operate on the old insurance payments. I get it. We changed to an older dentist who accepted the insurance, but only to a point. So, we started paying a bit more because the dentist is in our neighborhood and we liked him, A LOT. Then last year he sold to a younger, brilliant dentist. So far, the insurance plan has not changed, but I get it--costs have increased, wages have gone up, their insurance coverage is more expensive. I cannot even imagine what the newer equipment must cost. I'm just thankful that we have dental insurance at all because there are so many who don't.
ReplyDeleteYou make some great points, but your last sentence is the one that really resonated with me.
DeleteThat's nuts and so wrong.
ReplyDeleteThat really is shameful. I am so sorry.
ReplyDeleteFor sure they should have told you before your appointment I used to work for dentists and I never let a patient sit in the chair until they knew exactly what the visit would cost them!
ReplyDeleteIt sounds like your practice knew what it was doing.
DeleteWhen will companies realise that bad business looses them customers. Time and again I meet up with bad service and withdraw my contract.
ReplyDeleteGod bless.
IF, and it's a big IF now, there is another company or facility who will do the work you want and do it well. That is the conundrum in medical care right now, or at least in certain parts of the United Sates. Lack of providers is a huge problem. Medical people are going to big cities that offer lots of opportunities at better pay than they can get in smaller cities.
DeleteWell that is not good customer service and it's crappy that they treated you that way. I hope you find a dentist that takes better care of you and you get a response from your soon-to-be old dentist.
ReplyDeleteAs long as I don't get a bill I really don't care if I get a response or not.
DeleteOh gee! That's terrible! That would have really ticked me off!
ReplyDeleteI don't like when they aren't Transparent and intentionally don't inform of Change. When The Base quit carrying my Diabetic Meds, they waited until I'd called in the refills and then waited until I should be picking them up to then tell us they no longer provide any of them and I'd have to go straight Civilian and now have co-pays! If I could even find a Pharmacy that took our Insurance, which was yet another Challenge. Then, after I finally found one that did, another Change, suddenly the Insurance was calling me to ask why I was using that Pharmacy due to the Costs to THEM being so high! I explained that the Military Pharmacy quit carrying the Meds, let me run out before informing me of that fact, then told me I had the obligation to find my own Pharmacy in the Civilian Sector... that Pharmacy was the only one who would even take the Insurance and be able to acquire the main Diabetic injectable, which was now in short supply due to it being misused for Weight Loss Customers. Well, the Insurance told me they'd now Mail me my Meds in 3 Month Supply at a reduced Cost, no Postage, why they didn't inform me of that in the first place who knows? The Diabetic Specialist I used to see quit taking my Insurance too and then had the gall to Bill me a Year after I had quit using her, I'd never made the visits she was charging for and I'm certain she was committing Insurance Fraud... I told them so and that I wasn't paying for Visits I never made and it had been well over a Year that she quit taking my Insurance and refused to see me anymore or refill any Rx either. They've never gotten back to me, I doubt your Dentist Office will either now they know they've Wronged you.
ReplyDeleteI doubt I'll hear from the dentist office either.
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