Thursday, October 6, 2011

Horrendously Over Charged... Part 1

Our dental experience didn't sit well with me. I've been emotionally a mess the last few days about the obscene amount of money everything was costing us... with what should be really awesome dental insurance.

After talking with other people about it I knew something was wrong with the amounts we were charged. While I was at work I went ahead and printed out my dental policy. It doesn't make that much sense to me since I didn't know terminology, but I know for starters when the Root Canal line doesn't say $1,710.00 there's an issue... especially since the line read $205.00.

So I called the dental office at 1:00pm and told them I suspected we were incorrectly charged and that i'd like to meet and sit down and go over all the charges and fees line by line. The told me to come in the same day at 4:30pm.

When I went home to wait, I called my dental insurance company (Delta Care USA) where a nice gal transferred me to a wonderful man who went over my policy with me line by line. He had me mark the correct prices on my print out so I could compare everything with the office gal. If he was right, their office's mistakes would be astounding. 

The $420 deep cleaning ($105 per quadrant)... should have been free...

Our $140-$180 per filling (& we had 4 of them)... should have been $45, $55, $65, or $75 each depending on where they are for posterior... & free for the front (for nice pretty clear composite... not metal or anything like that).

If we needed a root canal, it should have been, again at max, $205... not $1,710.00

And the onlays.... for Porcelain/ceramic should have been $165.00 not the $550 she quoted me... and I hadn't a clue if that would also fly for the Epox... but it shouldn't be $840.00... that's for sure.

The wonderful man also told me if they hassled me that I should have them call him on speaker phone and have a conference call with their office and the dentists office.

I just sat there in shock at home while I waited for my husband to get home from work. It was raining and I just grew antsy. I ate Nutella... I tried to distract myself from my thoughts with TV... but it wouldn't work. I didn't know if we would feel relief and get everything sorted out... or if for some reason we'd still get nailed with a $840 charge when we should have only had to pay $160...

Not to mention that all this mess is attached to a brand new loan... 

I left the conversation with the insurance rep just feeling swindled and that they tricked us into upgrades we shouldn't have needed.

Was this going to be one of those $3,000.00 mistakes you hear about in the news or on radio shows??????

When my husband got home... we went to their office....  and I cried on the way back home.

The office gal told me they had the wrong policy listed... and instead of apologizing to me, she refused to make the quick 5 min call to my insurance company to verify my plan. It was against company policy to make the call there or to tell me what my new pricing structure would be if they verified that that was indeed my plan.

It didn't matter that I had the original copies from my insurance company with me stating my plan # (in addition to the plan booklet itemizing costs)... Instead I was told that they would call tomorrow and then contact me to let me know IF any revisions were to be made to my loan once "they" verified my insurance plan # was correct...

and then she told me we would only find revisions for the fillings and the cleanings... not the EPox Onlays....

When I tried to explain that when faced with the choice of a $550 ceramic/porcelain onlay that could chip and lead to an automatic root canal costing $1,710.00 it was an easy choice to choose the $840 EPox onlay instead... but if we would have know that a root canal would have only cost us $205.00 and the ceramic/porcelain onlay would have only costed $160 our decision to pay $840 for EPox would not have happened... but apparently things have already been sent off... (or they will check into that).... and it looks like they are going to stick us with the Epox cost.

I feel like we are being held at ransom for some clerical persons error.

After crying and some how managing to get the car home, I called the insurance company again.  I explained that they refuse to conference call them and verify my plan number... and while I was on the phone they pointed out a few very important details the dental office left out.

They can't charge me $840 for the EPox... My policy states that they can only charge me $320 over the cost of the $160 Ceramic for ANY name brand product.... So thankfully that alone will drop our inlays by $360.00 a piece. (Its still $480 a piece, but if we are stuck with that choice i'd rather pay $480 than $840)... but i'm still going to contest it.... but if all these charges eventually get fixed up tomorrow, at max it looks like our bill should be $1,740.00

Oh and get this... The man from the insurance company told me to request an EOB for my account since they are my primary dentist. Essentially an EOB is a list of every bill and procedure i've had with them.... and if they charged me for something they shouldn't have, they HAVE TO refund me any amount I was over charged since my policy hasn't changed since day 1...

and I distinctly remember getting charged for a deep cleaning during my first doctors visit.


  1. Oh my! That dentist sounds like a crook. If they don't refund you, I'd report them.

  2. Insurance fraud-call to state insurance commission

  3. I am glad you double checked - something seemed fishy - I could smell it all the way over here in Texas.

    I am going to start getting second opinions on my dental work. I don't have insurance - thankfully I can usually pay out of pocket - but that is no reason not to shop around, especially if they are not being nice to you.

    Keep us updated!