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  #1  
Old 10-27-2004, 01:40 PM
mditter
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Cross-out and Initialed Dentist Forms, Is this binding?


What is the name of your state? CO

A year ago I went to the dentist and instructed them to only perform procedures that would be covered by my insurance company. The receptionist called my insurance company to determine what was covered.

When signing in the day of my appointment, I crossed out and initialed the clause specifying that I would pay above what insurance covered. (i.e. I will not pay for what insurance doesn't cover). The dentist did not refuse me service.

However I was sent a billed for a procedure that my insurance doesn't cover.

I paid the bill to keep from collections, do I have a case in small claims to recovered what I paid since I updated the form and initialed it.
  #2  
Old 10-27-2004, 06:37 PM
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Join Date: Feb 2002
Location: Nashville,TN
Posts: 15,706
What kind of dental plan do you have ?? Its it 100% for covered procedures or is it something like 80/20 where they pay 80% and you pay the remainder ?? You need to be sure of what your coverage is before you try dragging people into court.
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"Knowledge is Power - use it as you see fit !

I am not a lawyer or a member of the legal profession. My advice is based on research and experience, my own and others, some who practice law. You decide for yourself what actions you do or do not take from my advice.
  #3  
Old 10-28-2004, 02:12 PM
mditter
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my coverage is 100% of approved procedures with $10 copay. Thats why I requested the receptionist call my insurance company to verify what was covered..... and more importantly thats why I crossed out the line saying "I agree to pay above and beyond whatever my insurance company pays"

So since I never agreed to pay above what my insurance company pays.... do I have to pay it?
  #4  
Old 10-28-2004, 06:50 PM
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Join Date: Feb 2002
Location: Nashville,TN
Posts: 15,706
IF they performed procedures that were not covered, then yes, you have to pay it. Did they ever call the insurance company or submit a treatment plan ??

If they agree to accept 100% from the insurance company for coverred procedures, then they CAN"T bill you for anything more, it would be a violation of their agreement with the insurance company.

Your crossing out of the form may have no weight to it at all - not unless the dentist ALSO initialed agreement.
__________________
"Knowledge is Power - use it as you see fit !

I am not a lawyer or a member of the legal profession. My advice is based on research and experience, my own and others, some who practice law. You decide for yourself what actions you do or do not take from my advice.
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