Dental services

[lawbird]

What is the name of your state (only U.S. law)? Pennsylvania

If a dentist performs services knowing that a patients medical insurance has not kicked in yet and then the patient looses his job and insurance to what extent is the patient liable to pay for those dental procedures. At the time of service the patient was not aware of the waiting period for the procedure the dentist performed. Obviously a person should be aware of his medical insurance and what procedures are covered but on the flip side a dentist should also advise the patient that the procedure he is about to perform is not yet covered under the terms of his coverage. Again, to what extent is the patient now liable for the dental procedures that were performed.

 

[Ohiogal]

What is the name of your state (only U.S. law)? Pennsylvania

If a dentist performs services knowing that a patients medical insurance has not kicked in yet and then the patient looses his job and insurance to what extent is the patient liable to pay for those dental procedures. At the time of service the patient was not aware of the waiting period for the procedure the dentist performed. Obviously a person should be aware of his medical insurance and what procedures are covered but on the flip side a dentist should also advise the patient that the procedure he is about to perform is not yet covered under the terms of his coverage. Again, to what extent is the patient now liable for the dental procedures that were performed.

The patient is completely liable.

 

[CSO286]

What is the name of your state (only U.S. law)? Pennsylvania

If a dentist performs services knowing that a patients medical insurance has not kicked in yet and then the patient looses his job and insurance to what extent is the patient liable to pay for those dental procedures. At the time of service the patient was not aware of the waiting period for the procedure the dentist performed. Obviously a person should be aware of his medical insurance and what procedures are covered but on the flip side a dentist should also advise the patient that the procedure he is about to perform is not yet covered under the terms of his coverage. Again, to what extent is the patient now liable for the dental procedures that were performed.

If you read your consent to treat form and financial disclosure, you would see a statement similar to, "We will submit our claim to the insurance you've provided to us as a courtesy to you. Please be aware that you are financially responsible for any unpaid balance after any insurnace payment or the whole balance, should your insurance decline payment."

You are responsible for seeking care that is covered by your insurance. It is not the service provider's job to ensure your coverage is up to date and accurate. You are responsible for payment--period. If that payment comes in the form of your insurance, then, great. If it comes directly from you as private payment, then that's great too.

You are required to know the terms of your insurance--whether or not a waiting period exists--that is your job, not the service provider's.

 

[cbg]

And if the patient is not aware of a waiting period, how do you expect the dentist to be? The patient only has one insurance policy to worry about - do you seriously expect that the dentist has the details of every one of his patient's insurance plans at his fingertips?

FYI, not all dental plans by the same carrier are identical. Knowing that you have coverage through Delta Dental or Prudential or Blue Cross Blue Shield does NOT mean that he knows the specifics of your plan.

 

[Antigone*]

What is the name of your state (only U.S. law)? Pennsylvania

If a dentist performs services knowing that a patients medical insurance has not kicked in yet and then the patient looses his job and insurance to what extent is the patient liable to pay for those dental procedures. At the time of service the patient was not aware of the waiting period for the procedure the dentist performed. Obviously a person should be aware of his medical insurance and what procedures are covered but on the flip side a dentist should also advise the patient that the procedure he is about to perform is not yet covered under the terms of his coverage. Again, to what extent is the patient now liable for the dental procedures that were performed.

The patient should not have sat in the dentist chair until THEY were certain that their insurance was in order. The patient needs to pay for the services rendered.

 

[lawbird]

Thank you for everyone's reply. I was pretty certain the patient was liable for all services but it doesn't hurt to ask and is a good reminder to understand your insurance coverage and rea the fine print.