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Health Forum    Dental

ThePrincess!
My dentist wants me to pay up front and have my insurance company reimburse ME?
I just went to the dentist today and had a filling. I have dental insurance, but the dentist wanted payment up front for the services.

The receptionist said they require payment in full for the services on the day of service, and then they will send the insurance claim in to the company and eventually I will receive a reimbursement check.

Isn't that what INSURANCE IS FOR??? So you DON'T have to pay?????

I don't handle the cash in my family, so after much arguing about requiring payment up front, the receptionist agreed to let me walk out withouth paying, but expects me to have my husband pay by tomorrow.

It just doesn't seem right that the dentist gets cash up front for the work, and then makes ME wait to get reimbursed by the insurance company... what the heck?
Additional Details
..the recep. said this is their "POLICY" and everyone has to do it.

(I didn't have insurance before this so I just always paid up front, so this is my first experience with insurance at this office)
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Silent Suicide
Rating
That sounds strange to me, I can understand if ou had some sort of co-pay for any work done, but full payment up front??? I'd call your insurance provider and make sure that they would even reimburse you before you go back to that dentist.

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bobe
Rating
To me it sounds like your Dentist doesn't trust that your insurance will come through at all. Or he may feel your not credit worthy and wants your payment up front. In either case, he should figure what amount if any you are responsible for, collect that portion only from you and remit the balance to the insurance company and settle the account from insurance. That is how it normally works. Ask your dentist why he can't do it this way. Or if you do have to pay "cash upfront" and no exceptions are allowed then ask him for a 10% discount for a cash transaction. That is customary and it will be worth your while since then you will have to wait for your insurance company to reimburse you. Be sure to follow up with your insurance company for proper reimbursement. Good luck! It will work out.

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suepeaches
i'd call your insurance company........
that is kind of weird........
before services my dentist finds out what the insurance will pay and tells us what we need to bring before the treatment......call your insurance find out what they will pay and when you will get reimbursed or find out what they expect you to pay and just pay that..........and then find a new dentist

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sammyj
Rating
tell em to get stuffed and as for the receptionist agreeing to let you walk out well whats she going to do about it she cant exactly stop you from walking out,tell them both they will have to wait til you speak with insurance company and if they dont like it then toooo bad.

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linz_b
find another dentist asap. that's just wrong.

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Bill
Find a new dentist. Most dentists know how much the insurance will pay and may ask you for the difference in what the insurance pays and the dentist charges.

My dentist submits my charges to insurance and only after they receive payment will they bill me any additional if required.

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Vanka
call the insurance company. dont do that. It might be a rip off. Maybe the insurance doesnt support that dental center. I would check with my insurance or Medicaid.

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jeanniep
they can do this, some doctors area asking for payment at time of service weather you have insurance or not.
you need to ask them for a discount if they are asking for this, reason being if you have to file all the paper work and wait for payment then ask if they will give a discount. if not, since you have already had work done and your Friend got you out the door, just let them know you don't have the money but can pay your co/pay (if any) and pay you when you get insurance money, it's worth a try.

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speak up
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you are very naive--would you work for someone,and wait to be paid by someone else???-i think not

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melfred_20
Rating
Alot of dentist are that way now. But if you have insurance you shouldn't have to pay up front unless the insurance doesn't cover the entire amount. Even then sometimes they get the amount wrong and you end up over paying. Sometimes if you talk to the dentist and not the receptionist they are more understanding since they get paid to be like that so they get their money. I would look for a new dentist if that's how its gonna be.

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Liz A
Sounds like you have Delta Dental. Some insurances take so long to pay the bills that the dentists don't want to wait that long for payment. Therefore they want you to pay and you to wait for the reismbursment.

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Jody
I've had that happen before. I would make sure you tell the ins. co. about this. Usually when a claim is made the dr won't tell the co. that they already got paid, so then they get money twice. I'd make sure you never use this dentist again. Also keep calling the ins. co. to track the claim so that you make sure you get your money back.

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Stina Lady
Rating
It depends on your insurance on how they do it. Some companies only reimburse you after the initial visit (like yours) and others will pay the whole amount or a percentage. It could be that you went to a dentist that was out of network and that is how your insurance company handles out of network dentists. I would recommend checking with your insurance company to make sure that the dentist office was correct and go over your coverage.

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Pam
Rating
Not all insurance companies work this way, but it is not unheard of. I once had dental insurance that worked the same way.

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Pritam B
Rating
A lot of dentists work this way. It is pretty standard actually. Insurance companies are like the mafia: they take your money up front and promise 'protection'. However, you have to live with them because the government and high health costs force you to.

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dane_62
I don't know as much about how this works for dental insurance as i do for medical. It's what is called Not Accepting Assignment which basically means the provider doesn't want to deal with the insurance, they might fill out the claim for you but after that it's your problem.

This is only allowed for out of network providers on a PPO type plan. Your best option is to call you insurance company, find out if this dentist is in network. If not find one who is, for this specific bill, if you can afford it pay it and be done. If not file your claim wait till you get the check from the insurance company and then pay it. The dentist office can't do anything to you but send you bills for the first month or so anyway.


If they are in network then they're really jerking you around and your insurance company does some leverage with them to make them accept the insurance.

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Bill
It's the doctor's business and he can require payment in full if he wants - but I would shop for another dentist that will accept your 'estimated' portion. Once insurance settles with the dentist, you will be billed for anything remaining.

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BLONDIE
This practice is totally honest. The dental office where I used to work was not a Blue Cross preferred provider, meaning we were not in their network. We could file patient's claims for them, but blue cross would not pay us directly,they would send the check to the patient. Some patients were getting their dental work done then keeping the money that came to them in the mail. The patients were actually making money,not us! We could not trust that patients would bring in the checks blue cross sent them ESPECIALLY FIRST TIME PATIENTS. That may be what's going on here, nothing against you personally, the dr may have been burned in the past and asking for payment up front is the only way they KNOW they will be paid. You will be reimbursed by your insurance.

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Pink Cowgirl
Rating
This is alot of times how my office works, and I'll tell you why.

For one thing, we are out-of-network. Therefore, our patients will have a higher copay in our office than in an in-network office. Also, since we are out of network, we have come across a few insurances that will not pay us, Delta being one of them. We have also seen cases, for whatever reason they had, that the insurance company sent the payment to the patient instead of us, and the patient I guess thought they were getting free money and spent it. When we discovered what had happened and tried to contact the patient to get them to pay us the money, they have said "We don't have any money right now." .

Most of the time, we do allow the patient to pay only a copay and we file the rest on the insurance. Sometimes, if a patient is getting a large amount of work done, we will require them to pay more than their copay. Once their insurance pays, we will refund them any money they overpaid. The reason we do this, is to cut down on billing. It costs dentists alot of money to send out statements every month, trying to collect money from patients for services that their insurance company didn't cover.

If we do expect a patient to pay for their services up front, and this is usually on large procedures or where they are financing their work, we always check the box on the insurance claims that will tell the insurance company to send the check directly to the patient, not us. If a dentist does this, they WILL NOT be getting paid twice, as another answerer suggested.

Many dental offices are actually deciding not to file insurance anymore, and are making all patients pay up front and then the patient will get reimbursed by their insurance company. This insures that the dentist is going to get paid for their services and then they don't have to worry about billing a patient later on for the amount that the insurance company didn't cover. Believe it or not, it is much easier to get a patient to pay for the services when they are done, than to try to get them to pay a bill later on.

I understand that it is hard to understand why some offices do this, when you aren't in the dental field, but more and more offices are doing this nowdays, and actually many continuing education courses are telling them to do this, because it means that they only have to deal with their patients, and not with insurance companies.

In my office, we actually let patients know up front that it is a curtesy that we file their insurance for them, not something that is required. We are not contracted with any insurance company, therefore we don't have to follow any rules set down by an insurance company. And believe it or not, we still have tons of patients.

As another answerer said, you are the one with the contract with your insurance. Unless your dentist is a PPO provider, he isn't in a contract with your insurance. Why should he have to wait to get paid for his services? Would you go to Walmart and buy $300 worth of groceries and then tell them you'll pay them part of it and they will get the rest of the moneylater? They wouldn't do that would they? Why should a dentist do the work and then get paid later? I certainly still expect my paycheck every 2 weeks, and I am not going to wait for my dentist to get paid before he can pay me. NO WAY NOT HAPPENING!

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The girl is a geek.
Rating
Unfortunately, many insurance companies will nit pick with the doctor or dentist over valid charges. They do not have the manpower to have a full time person deal with these issues...if they did, your rates (and mine) at the office would go up to cover the pay for that person or persons, whichever the case may be. Your insurance company is probably known for not paying up properly and in a timely manner.

They will let you send the claim and if the insurance company wants to be poopy about things, then YOU deal with it.


You ARE still insured, you just don't get the money up front and this is becoming more and more common as insurance companies think of new ways to bilk doctors and patients.


Sorry. Welcome to the US health care system.

The people you need to be upset with are the ones at the insurance company, not the doctor/dentist.

This is rather common, I am surprised you haven't run into it before.....

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Amy P
I have heard of this. My dentist has a sign up front that says something about payment up front even with insurance but they never collected money from ME and I have insurance. It probably depends on the insurance you have and the office you visit.

The best thing to do is call your insurance company BEFORE your husband pays them to make sure you will be reimbursed and HOW & WHEN this will happen.

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streezaleodejanero
Rating
Because now a days insurance companies are slack on paying dentist, doctors, and the like. Alot of medical and dental practices are like that.

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Vera C
This is not uncommon. Doctors and Dentists how expect the majority of their patients to pay up front and then seek reimbursement on your own from your insurance company.

I went to a new Dentist about 2 months ago. I needed a lot of work done. The total cost was $2100. They checked with my insurance first to see what was covered. The insurance covered $1200 so I had to pay the rest up front. However, they did assist me with filing my claim.

Welcome to Health Care Coverage in the USA!

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plmdmd
Rating
Every insurance is different and there is as much different insurance as there is patient.. Your dentist cant know everything about every patient's insurance. some time things are covered, some time they are not. some time its 100% covered, some time its 50%..

The dentist cant play with all those stuff, thats why you pay, he gives you the paperwork, and you send those and receive your reimbursment.

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bree
Rating
I thought that was common practice. My current dentist, oral and maxillofacial surgeon, and and former dentist, all require payment upfront.
Your dentist will not be paid twice. Your insurance company will send you a check to reimburse you.

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lila_tran
There are a lot of dentists who are choosing to go this route..if you call any random dentist and ask about insurance they will tell you that they bill your insurance as a courtesy to you, but ultimately you are responsible for paying for services rendered if your insurance does not pay. Insurance payments take a minimum of 2 weeks on up. I, personally, have sat on the phone with the insurance companies to try to get them to pay our office for services rendered months ago. Insurance companies can and have been a huge headache for dentists and doctors. Anywhere you go where they provide you with service..payment is expected at time of service. So why would this surprise you? For the dentist offices that choose to run their offices this way is not a bad thing. The dentists don't want their front staff to be on the phone all day trying to chase payments, that's not what they pay us for. It may not be good for you as a patient to pay for all the treatment out-of-pocket, but you are advised of the costs before you come in for treatment. You're lucky that they will send the claim in for you, most "fee for service" offices hand the filled out claim to the patient and let them deal with sending it in. Insurance is not there so that you don't have to pay for anything. It is meant to offset your out-of-pocket expenses, that's all.

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Rachel M
it can work either way, but this is your own fault. You should have checked with them before beginning treatment to determine their policies.

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h_carlin
A lot of dentists and doctors are doing that now...they are tired of waiting for the insurance to pay...so they want there payment in full, it is stated on the desk, door, wall....whatever...See someone else if you do not like to do this...sad thing is this is the way they are trying to go, some insurance companies do not pay a bill for 6 months...and that is why they are fed up with them...It's no big deal if you pay up front or not, you will get reimbursed, after you fill out your paperwork as well of course...

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Nancy Kay
Everyone has their own billing policy. Why shouldn't he get paid for his work right away...why should HE have to wait? Read your insurance (if you can) and you'll get the idea that they are in contract with you, not him, and he is not obligated to accept payment first from them and then the remainder from you. Sorry...next time discuss billing arrangements with a dental or medical professional BEFORE they render services to you...that way you won't have any unexpected (although totally legal) surprises...

P.S. You don't handle cash?? Your husband does??? Honey, your teeth are apparently the least of your problems, then...yoy!

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Godzilla Gal
Well try to see other over point of view here . They have to pay rent - payroll ect. Sometimes they get sued , costs go up an insurance disputes payments , and the dentists get screwed up . Imagine your a dentist what would you do ?
Charge up front and skip the bull right ?

Plus you did get the service , you would not expect to walk out of a store with out paying right ?

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MK
Rating
If your dentist is not a "Participating Provider" the insurance check from Blue Cross Blue Shield is automatically sent to the subscriber. Most offices work similar to what your dentist does, but usually they require 50% down and the remaining balance at the time of insertion or completion. The insurance cannot be submitted until the work is complete and Blue Cross Blue Shield usually pays within 7 days. They are one of the fastest insurance payors I have ever dealt with. They will not pay for all your procedures at 100% though, so you won't receive a check reimbursing you the entire cost and they usually have a $1500.00 calendar year maximum.
Dental insurance is not medical insurance so most offices are similar to the one you are going to. Some offices have these policies because patients have taken the insurance money and never paid for the services rendered. People don't realize how far they are asking their dentist to trust them. In our office if you are an established patient for a couple of years we will allow payment plans, but they are usually only 3-6 months out, anything longer and people tend to forget to pay us and then we end up sending the account to collection.

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