Originally Posted by
Rockasilly
I hope somebody may have some experience in a situation like this and might have some ideas as to what to do.
I got stuck needing some dental care recently so I check with my insurance company and go to someone that was listed as one of their in network providers. The dentist office goes to verify my insurance prior to my appointment and the first insurance idiot on the verification line couldn't find me but I did get them back on a call with a different insurance representative to verify that I am indeed in network... Despite this the lady doing the biling insists that I will have to be billed/treated as OUT of network(I pay 100% upfront) and they would submit a claim and that I would get a check directly from the insurance company. BAD DECISION
I pay the 1088.00 on my credit card up front for a couple of pulp caps and a few weeks pass so I check on the claim to see it was processed as IN NETWORK and the claim check would be only $450.00!?!? To complicate my disappointment the check was not going directly to me like the billing lady at the dentist office claimed but back to the dentist office. The insurance company is kinda jammed at this point as I am thinking I need to file an appeal and a grievance but they are looking at it as I SHOULD have NEVER been charged in the first place by an in network dentist. A general agent claims rep called the office to explain that they should refund my money but the billing lady gave her a claim of "Yes we accept your insurance companies plans, but not this one!" After the insurance company gets ahold of the dentist office the billing lady at the office calls me irritated and blaming me saying hey this is what we agreed on, we just dont accept your insurance plan etc,... I explain to her hey I am stuck in the middle here, you swear you are out of network but the reps say you are in network and the claims process as in network so I am stuck to accept a check at your agreed upon rates and have to wait for you to get it so you can write me a check? She wouldn't budge though as she wasn't going to refund me a dollar. I had a couple of other calls with customer insurance reps throughout the day and they tried calling the dental office to better explain as they were from the actual dental claims department itself and the billing lady wouldn't take their call at all. Eventually she took the call towards the end of the day and an agent read her the riot act stating they were very much IN NETWORK and they should refund my money. The billing lady said she would have to talk to the dentist and will decide what to do.
What should I do? Should I initiate a chargeback NOW or should I wait for this billing lady to decide what she wants to do with the dentist? Is this legal or simply unethical at best? How do I get this made right? I really need to dig deep and find my inner Todd Witteles because I feel I got screwed and should never have thought this would work out nice and neat.
Try living in a country that regulates profit based health care.
Land of the free jackals. Don't care, zero sympathy.
Write it off. You live in the freest nation of all times. Enjoy
Buy a pair of flag embossed shorts, that may help.
Fuck you btw and you're wall of sadness