Patient question – insurance
Provider: CIGNA
State: CA
I went to a dentist listed as in-network on Zocdoc for a 6-month cleaning as a new patient.
Before the visit, I provided my insurance information and confirmed that I was covered.
I had a cleaning + X-rays + 2 fillings. The fillings were not necessary. I paid for half the cost of the fillings out-of-pocket in the office before I left.
Turns out he is NOT in-network and so am being billed out-of-network costs. Dentist billed $1884. Plan paid $254 and I received a bill for $1080. I’ve already paid $550 in the office. So this is in addition to that.
I’m not sure what is going on but the bill seems exorbitant for services rendered. They had said that I’m responsible still and that I need to pay the balance that insurance didn’t pay, however I feel that since they advertised as being in-network and confirmed my coverage, it doesn’t make sense that I should pay this. Do I have any recourse?
I have already paid the $550 of my half for the fillings (we discussed my final out of pocket costs for these in the office). I said if I had known he was out of network, I definitely would not have agreed to the services or even come in for a cleaning (why would I go to in out-of-network provider for a service that is normally 100% covered in-network). Even he agreed to take off the charge for the fillings, which I don’t see as much of a discount because I already paid what we agreed was my portion. Then that leaves the cleaning, so on top of the $550 I’ve already paid, they want me to pay the difference of $650. So to me if I’ve already paid the $550 for the filling (and he’s knocking that off) that means I’m essentially paying $1200 for a cleaning. Further, on Yelp he advertises $140 for a cleaning + x-rays + new patient exam (assuming this is for non-insurance).
I’ve contacted Zocdoc who said that they actually do guarantee the accuracy of insurance coverage and they need to honor the in-network cost. So they have contacted the dentist about it on my behalf, but I don’t know how much leverage they actually have here.
What recourse do I have so this doesn’t go into collections and affect my credit? If it were even remotely reasonable, I would just pay it to not deal with it anymore. But this just seems so shady.
submitted by /u/between-seasons
[link] [comments]Patient question – insurance Provider: CIGNA State: CA I went to a dentist listed as in-network on Zocdoc for a 6-month cleaning as a new patient. Before the visit, I provided my insurance information and confirmed that I was covered. I had a cleaning + X-rays + 2 fillings. The fillings were not necessary. I paid for half the cost of the fillings out-of-pocket in the office before I left. Turns out he is NOT in-network and so am being billed out-of-network costs. Dentist billed $1884. Plan paid $254 and I received a bill for $1080. I’ve already paid $550 in the office. So this is in addition to that. I’m not sure what is going on but the bill seems exorbitant for services rendered. They had said that I’m responsible still and that I need to pay the balance that insurance didn’t pay, however I feel that since they advertised as being in-network and confirmed my coverage, it doesn’t make sense that I should pay this. Do I have any recourse? I have already paid the $550 of my half for the fillings (we discussed my final out of pocket costs for these in the office). I said if I had known he was out of network, I definitely would not have agreed to the services or even come in for a cleaning (why would I go to in out-of-network provider for a service that is normally 100% covered in-network). Even he agreed to take off the charge for the fillings, which I don’t see as much of a discount because I already paid what we agreed was my portion. Then that leaves the cleaning, so on top of the $550 I’ve already paid, they want me to pay the difference of $650. So to me if I’ve already paid the $550 for the filling (and he’s knocking that off) that means I’m essentially paying $1200 for a cleaning. Further, on Yelp he advertises $140 for a cleaning + x-rays + new patient exam (assuming this is for non-insurance). I’ve contacted Zocdoc who said that they actually do guarantee the accuracy of insurance coverage and they need to honor the in-network cost. So they have contacted the dentist about it on my behalf, but I don’t know how much leverage they actually have here. What recourse do I have so this doesn’t go into collections and affect my credit? If it were even remotely reasonable, I would just pay it to not deal with it anymore. But this just seems so shady. submitted by /u/between-seasons [link] [comments]Read Morer/HealthInsurance