Amethyst
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
- Joined
- Dec 21, 2008
- Messages
- 12,689
My dental plan through work is better than no dental insurance, unless one has no teeth or perfect teeth. The premiums are paid with pre-tax money, in effect reducing the premium by our 41% combined federal, state, and Medicate tax rate.
The problem is that BC/BS is considered our "primary" insurance, so the dental office must first bill BC/BS; wait for a BC/BS statement refusing to cover the billed procedure; then bill the dental insurer.
The dental office doesn't like to wait months to be paid, so they charge me their office rates up front, and tell me to go to my dental insurer to be "reimbursed" for the difference.
Whereas, the dental insurer says "No, don't do that! We don't reimburse you, because you paid the dentist and they have the $$, not us! Your dental office is supposed to charge you the negotiated rate up front."
Last week, I had routine preventive care, and the dentist looked at my mouth for 30 seconds because I complained of pain in one area. My dental co-pay should have been zero, but the office charged me $44 which they said was the BC/BS co-pay for preventive visit plus brief oral exam. I spent an extra 10 minutes negotiating my way out of it. Fortunately I had my insurer's 2010 co-pay list, and the dental office was able to contact the insurer to verify that I was paid up. So I was released with zero up-front charge, but a "If we have to, we'll still bill you" attitude. I'm sure that over the next 2 months I'll get 3 different statements that will need to be rectified.
Amethyst
The problem is that BC/BS is considered our "primary" insurance, so the dental office must first bill BC/BS; wait for a BC/BS statement refusing to cover the billed procedure; then bill the dental insurer.
The dental office doesn't like to wait months to be paid, so they charge me their office rates up front, and tell me to go to my dental insurer to be "reimbursed" for the difference.
Whereas, the dental insurer says "No, don't do that! We don't reimburse you, because you paid the dentist and they have the $$, not us! Your dental office is supposed to charge you the negotiated rate up front."
Last week, I had routine preventive care, and the dentist looked at my mouth for 30 seconds because I complained of pain in one area. My dental co-pay should have been zero, but the office charged me $44 which they said was the BC/BS co-pay for preventive visit plus brief oral exam. I spent an extra 10 minutes negotiating my way out of it. Fortunately I had my insurer's 2010 co-pay list, and the dental office was able to contact the insurer to verify that I was paid up. So I was released with zero up-front charge, but a "If we have to, we'll still bill you" attitude. I'm sure that over the next 2 months I'll get 3 different statements that will need to be rectified.
Amethyst