Very Confused with Communication Between Insurance and Office?!


Question: Very Confused with Communication Between Insurance and Office?
I have dental insurance and got a mouthguard. Before I got fit for it, the office called my insurance and left a message saying I'm 100% covered for all services in my treatment. However, after getting my mouthguard I got my EOB statement and a main bill from headquarters (this offic looks like its a franchise) and the insurance stated it didn't cover it and I owe $500 dollars for it!
I went in to the actual dental office and showed them the bill. The receptionist was very nice and said perhaps it was just a confusion and EOB's don't always represent a bill or what a patient owes. I went for another assessment this week, and when I was going out...the office staff said I don't need to check out and no one at the office has required me about payment.
I'm confused...do I not owe or will it bite me back later?

Answers:

Best Answer - Chosen by Voters

You should first call your insurance. Ask them if payment was made for the mg to your dental office and for how much. Also, ask if you are responsible for anything. Your insurance company will have all of this information. I don't know if you did but when you get treatment like this again, make sure that you get a pre-de from your insurance or a contract from your office signed by you and someone at the office.



In my experience the EOB tells you how much the insurance paid for the procedure and what you are responsible for. I'm guessing here but maybe the dentist office is going to re-bill it under another code to get the insurance to pay for it.

Personal experience and 5 yrs in HR with a self insured company




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