I was wondering if I could get your opinion about a recent situation I had with my dentist? A month ago I went in because they said I needed 2 onlay's put in on my bottom teeth and 2 fillings replaced on my upper teeth because of aging silver fillings. Cost me $1800 out of pocket and they said my insurance Delta will cover the rest. A few weeks later, I got 2 reimbursement checks in the mail from Delta made out to me. I figured it was reimbursement for maybe being over charged from my out of pocket. A few days after I cashed the checks, my dentist office manager sends me an email saying they know Delta sent me checks but they have no visibility on how much the checks are for. They asked me to come in with the break down sheet from Delta and with the checks for me to sign so they can cash them. They then said if I've already cashed them then I need to write them a check. Failure to do so and they will file a collections against me. I called Delta and they told me it's because the dentist who did my work is not in network and they cannot send checks directly to out of network dentists. I showed up to my dentist office to speak with the office manager in person. She told me the issue was caused because the dentist who treated me is in the process of "re-credentialing", which I'm guessing means she is in process of going back to in network? She said it was a one time glitch and wont happen again. Thing is I've been going there for 7 years and suddenly there is a glitch? After she looks over the Delta claims and I ended up having to pay them $1200 based on the checks Delta sent me. Sorry for long rant, the whole thing was really uncomfortable. If a dentist office says they accept your insurance provider, does not mean they are in network?
Although this was posted a month ago I hope that my input helps you understand the whole process with insurance better to prevent you from going through this again. I’ve been working as a receptionist for almost 5 months now and from what I’ve learned when a dental office takes your insurance that means that it’s because they are in network with them. Now sometimes this is NOT the case because some policies may be out of network depending on the employer and the plan that they chose for you, or that you chose. To break it down let’s say you have delta dental and your policy is in network, but there may be someone who has a different policy depending on their job and the state that their insurance is coming from, because Delta Dental has a lot of states, and sometimes these may be out of network with the office. Now when you schedule an appointment it is up to the insurance coordinator to get in touch with your insurance and figure out if you guys are in or out of network and proceed from there because both networks generate different percentages for what they will cover and what you will have to pay out of pocket.
Thank you.
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Is this updated to match 2020???
I was wondering if I could get your opinion about a recent situation I had with my dentist? A month ago I went in because they said I needed 2 onlay's put in on my bottom teeth and 2 fillings replaced on my upper teeth because of aging silver fillings. Cost me $1800 out of pocket and they said my insurance Delta will cover the rest. A few weeks later, I got 2 reimbursement checks in the mail from Delta made out to me. I figured it was reimbursement for maybe being over charged from my out of pocket. A few days after I cashed the checks, my dentist office manager sends me an email saying they know Delta sent me checks but they have no visibility on how much the checks are for. They asked me to come in with the break down sheet from Delta and with the checks for me to sign so they can cash them. They then said if I've already cashed them then I need to write them a check. Failure to do so and they will file a collections against me. I called Delta and they told me it's because the dentist who did my work is not in network and they cannot send checks directly to out of network dentists. I showed up to my dentist office to speak with the office manager in person. She told me the issue was caused because the dentist who treated me is in the process of "re-credentialing", which I'm guessing means she is in process of going back to in network? She said it was a one time glitch and wont happen again. Thing is I've been going there for 7 years and suddenly there is a glitch? After she looks over the Delta claims and I ended up having to pay them $1200 based on the checks Delta sent me. Sorry for long rant, the whole thing was really uncomfortable. If a dentist office says they accept your insurance provider, does not mean they are in network?
That is why is good to ask 1st ? If in or out of network ,but must offices that I've worked on are in with Delta...I'm just a DA n front desk. Lol
Although this was posted a month ago I hope that my input helps you understand the whole process with insurance better to prevent you from going through this again. I’ve been working as a receptionist for almost 5 months now and from what I’ve learned when a dental office takes your insurance that means that it’s because they are in network with them. Now sometimes this is NOT the case because some policies may be out of network depending on the employer and the plan that they chose for you, or that you chose. To break it down let’s say you have delta dental and your policy is in network, but there may be someone who has a different policy depending on their job and the state that their insurance is coming from, because Delta Dental has a lot of states, and sometimes these may be out of network with the office. Now when you schedule an appointment it is up to the insurance coordinator to get in touch with your insurance and figure out if you guys are in or out of network and proceed from there because both networks generate different percentages for what they will cover and what you will have to pay out of pocket.