Online Dental Insurance, I think my dental office is submitting claims twice.
Question: I think my dental office is submitting my dental claim to my insurance company twice. Making my company pay for the same services two times and charging me more as well.
I had a dental plan treatment that was going to cost $2200.00. My dental insurance company as a maximum limit of $2000.00. Keeping that in mind I paid my dental office at the time services was render $200.00 thinking that should be the end of the matter.
A month later I get a dental billing from the dentist for another $400.00. Confused I went on line to my dental insurance to see what was filed and it looks like they filed the same claim twice to my dental insurance company. Another thing is that it looks like my plan paid the dentist around $3500.00 which would be $1500.00 over my max limit. I an not understanding what is going on here. I tried calling my insurance company but the hold time is over 30 minutes.
I do not want to pay another $400.00 to my dentist when I think they are charging for the same claim twice. What should I do I hate worrying about it.
Answer: Call your dental insurance company and talk to the claims department. I know being on hold can be a drag but in your case I would deal with it until you are able to speak to someone. Many things can be going on. You could be reviewing the information wrong. Or there was an error in filing your claim in which case you would want to know that.
Insurance companies do not pay out more the set max limit. I am not going to say they do not make mistakes but normally that would not happen. So your policy may have roll over where all though they may look like the over paid they did not. You really will not know without speaking to someone over at the insurance company to know what was filed.
You may also want to contact your dental office for the complete billing statement for services render if they have not already given that to you. That way you can compare with the insurance company the billing amount and are able to go over your coverage based on the services that were done by your dentist.
With regards to your maximum limitation. $2000.00 is the dollar amount the company pays out but that dose not take into account your co-pay. Normally the company dose not pay 100 % of your dental care with the exception of maybe preventive services. It is likely that you would have additional cost if all you paid was $200.00 depending on your plan co-pays.
Mistakes happen from all sides whether it from the insurance company or the dental office. If it is a simple mistake it is easily correctly so do not worry to much over things until you able to find out what is really going on.
