Who can I contact when a dentist office stops using my insurance mid-treatment?
I have Assurant dental coverage began & go to Greenberg dental in Orlando, Florida.
The first few visits went fine and they used my coverage, but now they have handed me an invoice for almost ,000! When I asked why it was so high, I was told that they were not using my insurance for this. I asked why they weren’t using my insurance & I was told, "assurant doesn’t alway pay" & " the dentist is using a term for this treatment that isn’t covered by my insurance" I contacted Assurant, faxed the bill to them and was told that every procedure was covered & that they have never had an issue with payment.
The dentist office has been horrible. Assurant has called them twice for me to explain that I am covered and they still refuse to use my coverage. I am filing a grievance with Assurants help. But on Monday (11/27/06) I have an appointment! I must get this finished but they are telling me I must pay ,800 on monday to get treatment. who else can I contact? What do I do now?
Thanks for all the responses,
When I spoke with Assurant, I was told that they pay Greenberg Dental a, “Capitation “each month–a monthly sum, if clients come in or not–and because of this monthly payment, every person under the coverage of Assurant is given a specific set of co-pay prices for each dental treatment. So you see, the dentist office has already received payment for the services, so telling me that Assurant does not pay was either a lie told to me by the dental assistants or just a mistake made by them. Either way it was not true, and Assurant told me that "Greenberg Dental" is a franchise with which Assurant has a contract. I was told all of this by Assurant. I spent hours yesterday on the phone with them…
Thanks Corrin, but you see my insurance isn’t the type that you pay some and they pay some, I’m supposed to get a lowered rate for the services and the dentist office is already paid a monthly sum. The dentist has already received payment for November and since I am covered by Assurant, I should only have to pay the predetermined prices for each procedure.
Please keep the responses coming I really could use some help on this… I have to get this done Monday and I just want Greenberg dental to come to there senses and charge me the correct fees. But the dental assistants and receptionists seem unwilling to listen to anything Assurant or I have to say. Assurant was more than happy to proceed in an investigation of this but that will take some time… and I need this done on Monday… I can’t continue the way I am and also I will be going away on vacation next week, I can’t wait around… I need to speak to someone who can clear this up, someone that Greenberg will listen to. They are under contract with Assurant, and accepted their money… So they should treat me properly… well, perhaps I can contact the owner of Greenberg dental? It is a franchise, maybe if I speak to the corporate offices I can get somewhere?
Thanks again for all the answers, I really appreciate it!
ray
Tagged with: amp • appointment • assurant • corrin • dental assistants • Dental Coverage • Dental Treatment • dentist office • filing a grievance • franchise • greenberg dental • insurance • insurance quot • invoice • mistake • orlando florida
Filed under: Dentist Insurance
I would call your state medical board. What they are doing seems to be quite unscrupulous since they already started the work. I have never heard of a doctor refusing insurance once he accepted it and started the work. Good luck.
Contact your insurance provider. Typically, most dental insurance companies only cover so much per year.
couldn’t you file the claim with your insurance company yourself and still have them pay it??
Worst case you might need to go to another dentist until this is resolved.
ok, just relax! What I am understanding is that your dental office does nott ake assignment for this certain insurance company. It means that they will not submit the claims on your behalf because they have ahd problems before with payments from this certain company. So all you need to do is get the insurance claim forms filled out by the admin at you detnal office and they will tell you where to mail them. Your insurance sompany if services are covered will have a check out to you in about 10 business days. Hope this helps… Understandably it is the dental offices choice if they want to protect their assets and not take assignment on insurances. Pt pays cash and gets reimbersed themselves.
Corrin is probably right, but I seriously doubt any plan would cover more than $1,000-1,500 per year anyhow. YOU should have known this up front. A $10,000 treatment plan would max out your coverage, leaving you with $8,500-$9,000 out of pocket anyway. Simply changing a procedure code would not have had such a dramatic effect on the fees, I’m sure.
When you get that straightened out you might consider this company for your dental plan. http://www.AffordableDental4All.com they will save you quite a bit of money and its only $11.95 per month, much less than most insurance plans. Also there are no restrictions like insurance plans have.