M
MEH
Guest
Two months ago, I visited an endodontist to repair an abscessed tooth. During my initial visit I was in alot of pain and my face was badly swollen. While I was in that
condition, the endodontist informed me that a second tooth was probably going to
cause me the same problems so she strongly suggested I have it repaired,
too.
Before making the appts. to have both teeth fixed, I asked her receptionist if my insurance would cover the repairs. She said yes. I was never informed of the cost of the services or in any way advised that my insurance would not cover the entire expense.
My insurance covers 100% of most dental treatments with an annual limit of $1500. In the 12 years that I've had the insurance, I have never once even approached the limit. The dentist I'd used for 10 years always pre-approved large expenses through my insurance company before suggesting treatment. The endodontist did not do the same.
After I had all the work done, I learned the problem the endodontist diagnosed in the second tooth probably would not have caused me any trouble. It may have only been a small shadow on the x-ray. In other
words, its questionable if there was any problem at all.
The endodontist billed my insurance company for over $2000. The endodontist then sent me a $700 bill, which is the amount over my insurance limit. Again, the endodontist and her staff never advised me of the cost before doing the work and lead me to believe my insurance would cover the entire expense.
Am I required to pay the $700 since I was not advised of the cost in advance? Also, the treatment for the second tooth was probably not necessary in the first place. Do I have any recourse in this matter?
Thanks.
condition, the endodontist informed me that a second tooth was probably going to
cause me the same problems so she strongly suggested I have it repaired,
too.
Before making the appts. to have both teeth fixed, I asked her receptionist if my insurance would cover the repairs. She said yes. I was never informed of the cost of the services or in any way advised that my insurance would not cover the entire expense.
My insurance covers 100% of most dental treatments with an annual limit of $1500. In the 12 years that I've had the insurance, I have never once even approached the limit. The dentist I'd used for 10 years always pre-approved large expenses through my insurance company before suggesting treatment. The endodontist did not do the same.
After I had all the work done, I learned the problem the endodontist diagnosed in the second tooth probably would not have caused me any trouble. It may have only been a small shadow on the x-ray. In other
words, its questionable if there was any problem at all.
The endodontist billed my insurance company for over $2000. The endodontist then sent me a $700 bill, which is the amount over my insurance limit. Again, the endodontist and her staff never advised me of the cost before doing the work and lead me to believe my insurance would cover the entire expense.
Am I required to pay the $700 since I was not advised of the cost in advance? Also, the treatment for the second tooth was probably not necessary in the first place. Do I have any recourse in this matter?
Thanks.