Dentist Office Didn’t File A Claim On A Procedure Claiming That I Had Already Met My Yearly Deductibles , Which Wasn’t True.
April 6- visited a new dentist for a basic cleaning + exam. Further evaluation, decided to get a deep cleaning done (early stage gum disease) and get another crown replaced as they were giving me issues. Paid ahead of time based on their estimate of my benefits ($~1600).
May 8- got a filling done. They claimed I had already maxed out my yearly deductibles and had to pay fully out of pocket. (I know.. in hindsight, I should’ve double checked myself). Paid $280.
Later on, received my EOB for the April 6 claims (exam, X-ray, crown, and deep cleaning) saying that I only owed $700. Talked to insurance and the dentist office, they said I will be sent a check in 14 business days, which will be May 31.
The issue is I am faced with is I didn’t in fact meet my yearly maximums yet, and even if I did, my policy would still cover a % of the charge for the filling. However, when confronting the dentist office, they claimed that they hadn’t been paid by the insurance for the previous claims yet, so they are unable to make the claim until then. Talked to an insurance representative but she was useless so I’ll try again soon. What should I do from here?
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