Dental Office--Ventish - Page 2

[elephantmargaret]

I would write the dentist office. They may eat it. If not you've at least tried.

[texmati]

Originally Posted by llamalluv

I think you mean bait and switch.

And I wouldn't blame the doctor. It's not the doctor who is responsible for calling the insurance company to verify what will be paid for and what will not. It's the responsibility of the person who will have to pay for the mistake.

Most of the time, the doctor never even contacts the insurance company - an office staff member just enters stuff into the computer. If she enters the wrong code, the claim may not get paid (at best) or they could lose their license for fraud (in an extreme case).

Pharmacists have their hands tied when it comes to prescription prices, too. I know one fellow that wrote about a customer who has to pay for Imitrex out of pocket, and the price has suddenly gone up (due to a new similar drug called Treximet by the same company). This comment was a part of a rant about the unethical advertising practices, and several people asked to help her in some way by Paypal-ing some cash. He can't accept the help for her, because it is a violation of their contracts to give a discount on drugs to some customers - even though this isn't a discount.

yes ... I meant bait and switch. In this case, OP is saying that she only authorized the amalagam (sp?), because her insurance only covered that.

She should have been informed that that wasn't what her son was getting.

Believe me, when doctors know that they won't be getting their money from an insurance company, (I've dealt with self pay a couple times with MIL) they are waaaay more careful about billing.

[llamalluv]

Originally Posted by aquarian

yes ... I meant bait and switch. In this case, OP is saying that she only authorized the amalagam (sp?), because her insurance only covered that.

She should have been informed that that wasn't what her son was getting.

Believe me, when doctors know that they won't be getting their money from an insurance company, (I've dealt with self pay a couple times with MIL) they are waaaay more careful about billing.

She says she only authorized amalgam - but was that in writing, was it verbal, was it "my insurance will only pay for amalgam" with the "understanding" he would only use amalgam? Did she ask in advance what type of filling they would be using and when told composite did she then decline composite and tell them to use amalgam? Did she tell him amalgam but then sign a consent form that said something else?

There's a wide range of behaviors that people think is "authorizing" when in fact there was no formal authorizing process.

[texmati]

yup. and as we don't know which it was, I'm giving the op the benefit of the doubt.