Do dentist normally submit a huge claim to insurance company?
My dentist( in-network) has quoted me ~600 to get two wisdom teeth out (D7230 -tooth 32 and D7240 – tooth 1) with local anesthesia and that it would be covered by my insurance – no out of pocket cost for me. However, they have submitted a $3000 claim for the two teeth that were extracted. The total amount the insurance company allowed was $2211.
Is that typical for dentists to submit claims so they can take the maximum amount allowed by the insurance company for the procedure?
If so, wouldn’t that lower my annual cap ($2200) and decrease the available benefit for the rest of the year? – asking this because I still have to get the other two wisdom teeth out next year and would still want the plan to pay for the cleanings.
Or are they submitting this huge claim since it’s the end of the year and they want to use up my annual cap?
Thanks in advance! New to the US healthcare/ dental insurance system. (NY)
Also posted this in r/insurance but didn’t get a response.
submitted by /u/pinksushi123
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Do dentist normally submit a huge claim to insurance company? My dentist( in-network) has quoted me ~600 to get two wisdom teeth out (D7230 -tooth 32 and D7240 – tooth 1) with local anesthesia and that it would be covered by my insurance – no out of pocket cost for me. However, they have submitted a $3000 claim for the two teeth that were extracted. The total amount the insurance company allowed was $2211. Is that typical for dentists to submit claims so they can take the maximum amount allowed by the insurance company for the procedure? If so, wouldn’t that lower my annual cap ($2200) and decrease the available benefit for the rest of the year? – asking this because I still have to get the other two wisdom teeth out next year and would still want the plan to pay for the cleanings. Or are they submitting this huge claim since it’s the end of the year and they want to use up my annual cap? Thanks in advance! New to the US healthcare/ dental insurance system. (NY) Also posted this in r/insurance but didn’t get a response.
submitted by /u/pinksushi123 [link] [comments]Read Morer/HealthInsurance