HMO Dental Insurance issue with orthodontist

[crysredd]

What is the name of your state? CA

Hi. Hopefully someone can advise on this:
I have decent dental coverage for an HMO plan. The plan states that I pay certain amounts for xrays, records, etc and then I am supposed to pay a copay for each month that I am in orthodintic treatment. I was told that I would only need to be treated for 6-10 months. The patient charge schedule from my plan lasts for 24 months in total. The doctor wants to charge me as if I were having 24 months of treatment but is squeezing those amounts into 10 months. When I brought this to their attention I was told this:

"The average orthodontic case used to take 2 years to complete, but with advancement in technology and Dr. X's experience he can get you done much faster. Our office should not be penalized for being able to complete your case quicker, so in order for us to fully utilize your insurance benefit we will treat you for 24 months instead of the expedited 6-10 month plan previously mentioned. This would entail using the older appliances that are effective but take longer to finish and your appointments would be further apart as a consequence. We are under no obligation to use the latest and most effective brackets on your case."

So who is to say that they are using such advanced technology to speed my progress from 24 months to 6-10 months? I was never told this in the beginning. How is this regulated?

Please advise. Thank you.What is the name of your state?

[ecmst12]

You should ask your insurance company about this. Either this is something they know about and consider acceptable practice, or they're going to consider it fraud and take action against the doctor's office for it.