dental bill claim correction form

[mikemc99]

What is the name of your state? PA I had a crown done, and the office finally billed the correct provider on what my insurance is saying is a (duplicate billing) procedeure that can only be billed in a 5 year period. This is my first year with this insurance. It seems they billed a duplicate charge for 2 different days. I have advised the office to do claim correction form as instructed by the insurance co. They indicate they have to bill the insurance for the work done on the date it was done or it is insurance fraud. I explained the insurance said to do a claim correction form, but they still have not done it, or have provided me with proof on same.They turned the matter over to a collection agency, and they are calling, sending letters. I advised them of the dispute, but still get calls and letters on this debt that is collecting interest. The dates of service are 1/26/07, and 2/12/07, so this has been going on for quite some time. I'm hot now! How do I get the provider to comply with the insurance company, who is their "preferred" provider? My insurance Delta Dental is not the easiest to work with either as they probably don't want to fully explain to them how to do it. I believe the provider does not know how to bill correctly. How can I complain, or get them moving on this or get this resolved. I have asked to speak with the dentist to see if a correction can be made, but they do not allow me to speak to them when I call, as the office manager always intercepts the call, and yes's me to death, and blows me off. They also sent me a copy of a waiver form I signed indicating I was responsible for all balances not paid by insurance. I want to complain or seek legal action or something, as I do not want my credit affected, and want this matter over! I don't doubt I owe something, but I have paid for the services based on estimates almost every time I went in there. It was the most messed up billing procedures I ever experienced and still had a huge balance. Any advice?? I appreciate it. Thanks...

[randomguy]

Try calling your insurance company. As to get them to stop calling you and sending you mail is easy. Just google for CEASE and DESIST COLLECTION EFFORTS
here is a sample

Cheatem Collections
123 Fagetaboutit Ave
Chicago, IL

17 April 2000

RE: Account 5145454156

Dear Sir or Madam:

I request that you CEASE and DESIST in your efforts to collect on the above referenced account (SEE letter attached). It is my personal policy not to deal with collection agencies and I will only deal with the original creditor of this account.

You are hereby instructed to cease collection efforts immediately or face legal sanctions under applicable Federal and State law.

GIVE THIS LETTER THE IMMEDIATE ATTENTION IT DESERVES.

Cordially

Scott Free
[url]http://www.creditinfocenter.com/forms/sampleletter7.shtml[/url]

[Zigner]

Randomguy is giving terrible advice. Follow it at your PERIL!

[randomguy]

Originally Posted by Zigner

Randomguy is giving terrible advice. Follow it at your PERIL!

Please explain what is bad about my advice. Under the law , if he sends them c&d letter, they will have to stop contacting him. They will basically have 2 choices 1)sue him 2) sell the debt to new collection agency

[Chien]

Please explain what is bad about my advice.

Gee, so many choices. Where to start? You did ok with “call the insurance company”, but the OP has tried that, isn’t satisfied, is looking for more help and things went downhill when you began to “cut and paste”.

1) The debt is his and the insurance is legally secondary. (He probably even signed an acknowledgement of that pre-treatment.)

2) Given #1, the chances are better than even that they will sue, if he tells them to pound sand.

3) He doesn’t want his credit damaged. He’ll lose the lawsuit. He can cross-complain against the insurer and win on the information posted, but he still loses the suit against him. Recorded judgments damage credit, even if he recovers against the insurer.

4) Encouraging litigation in any form is, per se, not smart – even if he prevails against the insurer and is willing to go out-of-pocket to do it, the OP gets his own [satisfied] judgment. (Even if you’re going to front costs to prove a point, and you’re not suggesting that, are you?)

5) Or they “sell the debt to new collection agency”. Why? It’s fresh, it’s his and he’s there. They sue; they win.

Sometimes, I can appreciate how attractive this “tell them to stuff it” business can be to some of you, but you really don’t think it through, and that’s why you do get sued. This is boring and there’s no pleasure in making the list longer.

OP – healthcare providers commonly outsource billing. There is too much “non-healthcare” paperwork. Statistically, there is a very high error rate in such billing, despite it being done by “specialized professionals”. We don’t know whether your matter was handled in-house or out. However, if there is an error, I’d first contact my doctor/dentist directly and by letter, CRRR. I’d explain that I’d tried everything to resolve an error and with no success. I’d explain that the error is damaging my credit and may be moving toward litigation. I’d explain that, if it came to litigation, you would have to cross-complain against every entity involved and that would necessarily include the office. Ask him/her to take immediate responsibility for correcting the problem (and I’d ask who his/her E&O carrier is). Unlike randomguy, nobody wants litigation, but you must make your position firm and clear. And then offer an olive branch - any additional information and/or assistance to aid them. But go to the top of the totem; you’re getting blown-off now.

At least try it before inviting suit. We don’t know the amount, but you may get your wish, and your credit will suffer, even if you don’t.

[mikemc99]

thanks. I got through to the ins co and they are making some add'l payments. they commented this denist does not know how to bill correctly. I will owe some balance, but will look to fight any interest accrued for their mistakes. should I still look to threaten them to place on notice the E&O carrier or what advise would you give me on that...