So, I’m fairly confused on this dental insurance issue I have. In 2020, I had a wisdom teeth removal procedure done by an in-network dentist. For sedation, they charged me a total of $579, but my BCBS IL dental insurance stated the allowed amount for these sedations totals to $355.68. Since my insurance denied covering the sedation services for my wisdom teeth, I ended up paying that $579 amount as part of the total payment. If the allowed amount was $355.68, was I only supposed to pay that, even though insurance doesn’t cover that service? Also, they charged me $190 for a “therapeutic drug injection” that was not included in the explanation of benefits that BCBS IL sent me.
In total, the charged amount of the entire procedure (sedation, removal, extraction) was $1103, but the total allowed amount was stated as $740. The total not covered was $366, and my benefit amount was set as $307. I ended up paying the office $874 at the time of service. Was I supposed to only pay the $366 in total for the entire procedure? I called the office multiple times, and they told me that they were able to charge me over allowed amount for the sedations, since insurance won’t cover that.
I was told by a BCBS rep that I was overcharged, but that they could do nothing and it’s on me. Overall, I’m just very confused on exactly how much I was overcharged, and what my rights are in this situation. I’m fairly new to having my own health insurance, so I’m not sure on terms, or how to advocate for myself if insurance said there’s nothing I can do. Any explanation is appreciated, and I can try and go further into my billing details if that helps. Thank you!
submitted by /u/aftershaveocean
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So, I’m fairly confused on this dental insurance issue I have. In 2020, I had a wisdom teeth removal procedure done by an in-network dentist. For sedation, they charged me a total of $579, but my BCBS IL dental insurance stated the allowed amount for these sedations totals to $355.68. Since my insurance denied covering the sedation services for my wisdom teeth, I ended up paying that $579 amount as part of the total payment. If the allowed amount was $355.68, was I only supposed to pay that, even though insurance doesn’t cover that service? Also, they charged me $190 for a “therapeutic drug injection” that was not included in the explanation of benefits that BCBS IL sent me. In total, the charged amount of the entire procedure (sedation, removal, extraction) was $1103, but the total allowed amount was stated as $740. The total not covered was $366, and my benefit amount was set as $307. I ended up paying the office $874 at the time of service. Was I supposed to only pay the $366 in total for the entire procedure? I called the office multiple times, and they told me that they were able to charge me over allowed amount for the sedations, since insurance won’t cover that. I was told by a BCBS rep that I was overcharged, but that they could do nothing and it’s on me. Overall, I’m just very confused on exactly how much I was overcharged, and what my rights are in this situation. I’m fairly new to having my own health insurance, so I’m not sure on terms, or how to advocate for myself if insurance said there’s nothing I can do. Any explanation is appreciated, and I can try and go further into my billing details if that helps. Thank you!
submitted by /u/aftershaveocean [link] [comments]Read Morer/HealthInsurance