Best way to deal with shady dental billing situation? (The sequel)
April 20, 2022 10:40 PM Subscribe
The office of my now-former dentist is still trying to bill me for $1XXX more than what I was originally quoted for surgery. I've already paid what I was originally supposed to pay and have been trying to settle the remaining amount. Unfortunately I seem to have reached an impasse, and am trying to find the best way to resolve the matter (including possibly filing a complaint with the state dental board).
I've been involved a dispute with my dentist's billing manager ever since I went in for gum surgery in April 2021 and was presented with a bill (literally right after the surgery) where my responsibility was $1XXX more than what I was previously quoted. (Previously and previously). The billing manager finally agreed to resubmit their claim with the corrected coding (which was apparently causing the issues) but never did. It became a pattern where their manager would send me notifications of the balance due, I'd remind her that she was supposed to resubmit the claim, and then she'd back off...only to send another request for payment a couple of months later. I asked HR for help after the last payment request, and our company's insurance broker asked the provider to resolve the situation. I was optimistic at first, but the new manager at the dentist office now claims that the coding was actually correct. So there's apparently nothing more the provider can do. (I had forwarded over the original estimate and emails noting the original lower quote, along with other related correspondence. Unfortunately my conversation with the old office manager about the coding was done over the phone, and she obviously didn't leave any notes for her successor). So in theory the dentist probably still believes that I owe the disputed amount, though I haven't received any new billings or payment requests.
One good thing that came out of this was that the broker gave me the link where I can file a complaint with the state dental board (long story short, the post-surgery price-hike wasn't the only sketchy thing done by the dentist office). One suggestion that's been floated to me is that I contact the dentist office to inform them that I plan to file a complaint with the state dental board (maybe that'd persuade them to cut a deal to stave off said complaint. Maybe). I'm leaning in that direction myself, though I'm wondering if I should wait and see if the dentist office still plans to pursue this matter, or if they'll drop it now that the new manager is (hopefully) aware of the original estimate amount. Do either of these sound like good/bad ideas, or is there a better way to settle this? (I'm not sure I have that many options left if having the provider talk with them didn't accomplish anything).
I've been involved a dispute with my dentist's billing manager ever since I went in for gum surgery in April 2021 and was presented with a bill (literally right after the surgery) where my responsibility was $1XXX more than what I was previously quoted. (Previously and previously). The billing manager finally agreed to resubmit their claim with the corrected coding (which was apparently causing the issues) but never did. It became a pattern where their manager would send me notifications of the balance due, I'd remind her that she was supposed to resubmit the claim, and then she'd back off...only to send another request for payment a couple of months later. I asked HR for help after the last payment request, and our company's insurance broker asked the provider to resolve the situation. I was optimistic at first, but the new manager at the dentist office now claims that the coding was actually correct. So there's apparently nothing more the provider can do. (I had forwarded over the original estimate and emails noting the original lower quote, along with other related correspondence. Unfortunately my conversation with the old office manager about the coding was done over the phone, and she obviously didn't leave any notes for her successor). So in theory the dentist probably still believes that I owe the disputed amount, though I haven't received any new billings or payment requests.
One good thing that came out of this was that the broker gave me the link where I can file a complaint with the state dental board (long story short, the post-surgery price-hike wasn't the only sketchy thing done by the dentist office). One suggestion that's been floated to me is that I contact the dentist office to inform them that I plan to file a complaint with the state dental board (maybe that'd persuade them to cut a deal to stave off said complaint. Maybe). I'm leaning in that direction myself, though I'm wondering if I should wait and see if the dentist office still plans to pursue this matter, or if they'll drop it now that the new manager is (hopefully) aware of the original estimate amount. Do either of these sound like good/bad ideas, or is there a better way to settle this? (I'm not sure I have that many options left if having the provider talk with them didn't accomplish anything).
May be a good time to see if your local TV consumer reporter ombudsman wants to go to bat for you. They LOVE a case like this, and the threat of a TV exposure would make many shady billers back down.
posted by kschang at 11:32 PM on April 20, 2022 [1 favorite]
posted by kschang at 11:32 PM on April 20, 2022 [1 favorite]
Where I live I would go in to the office in person with printouts of the emails and anything else that's relevant, and if talking with the office manager in person doesn't get you anywhere I'd insist on talking with the dentist too, or whoever the owner of the practice is. Doesn't matter what the correct coding is, you agreed to the procedure based on the quoted price and if they made a mistake it's still on them to honor it. I would want them to either fix their insurance submission right there or give you a written assurance that they'll do so. YMMV about whether that would be a good approach where you live.
I'm not sure "wait and see" is a good idea since if you're in the US there's a danger they might send your bill to collections.
posted by trig at 12:25 AM on April 21, 2022 [4 favorites]
I'm not sure "wait and see" is a good idea since if you're in the US there's a danger they might send your bill to collections.
posted by trig at 12:25 AM on April 21, 2022 [4 favorites]
I want to echo this point:
trig said "I'm not sure "wait and see" is a good idea since if you're in the US there's a danger they might send your bill to collections."
Absolutely. Don't give them the opportunity to harm your credit rating.
Avoid having any phone or in person conversations if you can. You want emails or written correspondence. If you do have to speak with them, IMMEDIATELY send them an email to document the conversation. You want things said in writing, in case you have to take them to court.
If they're being shady with you, don't assume this is the first time they've done this.
posted by 2oh1 at 3:12 AM on April 21, 2022 [1 favorite]
trig said "I'm not sure "wait and see" is a good idea since if you're in the US there's a danger they might send your bill to collections."
Absolutely. Don't give them the opportunity to harm your credit rating.
Avoid having any phone or in person conversations if you can. You want emails or written correspondence. If you do have to speak with them, IMMEDIATELY send them an email to document the conversation. You want things said in writing, in case you have to take them to court.
If they're being shady with you, don't assume this is the first time they've done this.
posted by 2oh1 at 3:12 AM on April 21, 2022 [1 favorite]
Unless you are raising an issue about the treatment itself, the state board will not likely intervene over billing matters. Threats of reporting are not likely to help you resolve this.
If this is a matter regarding how much your insurance covered v how much out of pocket you have to pay, and not the actually fee for the service, you are better off trying to resolve it with the insurance carrier.
Most offices have boilerplate consent forms that state that regardless of what insurance you carry and how much they say they might pay, the patient is the one ultimately responsible for the bill.
Sorry this might not be what you want to hear.
posted by OHenryPacey at 8:19 AM on April 21, 2022 [1 favorite]
If this is a matter regarding how much your insurance covered v how much out of pocket you have to pay, and not the actually fee for the service, you are better off trying to resolve it with the insurance carrier.
Most offices have boilerplate consent forms that state that regardless of what insurance you carry and how much they say they might pay, the patient is the one ultimately responsible for the bill.
Sorry this might not be what you want to hear.
posted by OHenryPacey at 8:19 AM on April 21, 2022 [1 favorite]
If insurance paid for part of it, see what your insurer has to say about how it was coded. In any case, if it affects your credit score, file a challenge. And file a complaint with the dental board; if htey screw people routinely, one more report will help.
posted by theora55 at 9:28 AM on April 21, 2022
posted by theora55 at 9:28 AM on April 21, 2022
When this happened to me, I called the insurance company and told them the bill did not represent what they claimed, they sent the claim back to their office without payment. I never heard from them again. I don’t know if this would help you, but getting insurance companies involved can give you proof that the bill is not correct.
posted by waving at 9:52 AM on April 21, 2022
posted by waving at 9:52 AM on April 21, 2022
A link in BoingBoing reminded me that Consumer Finance Protection Bureau is still a thing. Their advice on medical debt is still solid.
posted by kschang at 12:29 PM on April 21, 2022
posted by kschang at 12:29 PM on April 21, 2022
Response by poster: Actually it was the insurance company that contacted the dentist office (this is why I usually try not to post too late during the working week, my bad), so they’ve already had their crack at the dentist (with no success). They also provided me with the link to the state dental board to make a complaint (instead of simply saying “sorry, you’re SOL”), so take that as you will.
posted by gtrwolf at 1:52 PM on April 21, 2022
posted by gtrwolf at 1:52 PM on April 21, 2022
I will point out that if you’re in a one-party-consent state you can record any in-person conversations you choose to have. This varies from state to state so be sure you are allowed before doing so. I am a big believer that it is much harder to be a passive-aggressive dick with a customer in person than on the phone or via email, but not everyone is comfortable with such things.
posted by Gilgamesh's Chauffeur at 10:17 PM on April 21, 2022
posted by Gilgamesh's Chauffeur at 10:17 PM on April 21, 2022
This thread is closed to new comments.
posted by gtrwolf at 10:53 PM on April 20, 2022