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Dental

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macksmom

Guest
I recently had to have a dental crown re-done- Now the dentist is telling me that neither one of my insurances (2 of them!) is going to pay for this work because the original crown was less than 4 years old. This amounts to $355.80 of which he is "willing to take" $177.90, and wants me to "come by the office to sign a financial agreement". I feel that I should have been notified before the work was done that the insurance was not going to pay for this. I also feel like that if it had been done correctly in the first place, I would not have had to have it redone.

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Linda
 


I AM ALWAYS LIABLE

Senior Member
<BLOCKQUOTE><font size="1" face="Arial, Helvetica, Verdana">quote:</font><HR>Originally posted by macksmom:
I recently had to have a dental crown re-done- Now the dentist is telling me that neither one of my insurances (2 of them!) is going to pay for this work because the original crown was less than 4 years old. This amounts to $355.80 of which he is "willing to take" $177.90, and wants me to "come by the office to sign a financial agreement". I feel that I should have been notified before the work was done that the insurance was not going to pay for this. I also feel like that if it had been done correctly in the first place, I would not have had to have it redone.

<HR></BLOCKQUOTE>

My response:

Oh, you're not going to like this, and I don't expect you to believe me - - for all I know, you may just be venting on this Board and will do as you believe no matter what is said here - - but, here goes anyway:

1. Your dentist is just that, a dentist. He's not your insurance agent, and he, nor his office is required by any law, to memorize your insurance policy. That's your responsibility. The dentist and his staff deal with innumerable insurance companies, and it's not up to him to "dispute" coverage decisions - - that's your job. If there's coverage, great. If not, the dentist, as a business person, looks to you, his patient, for payment of services rendered. He doesn't have to wait until your insurance problem is resolved. You are imbued, by law, to know the terms, conditions and all other perameters of your own insurance coverage. If you don't, that's not the dentist's fault or problem. He's a dentist, not an insurance agent.

2. With regard to the fact that your crown needed replacing, unless you can show malpractice with another dentist saying that what your dentist did was "below the standard of care in your community", there's nothing you can do. Dentistry is not an exact science, and everyone's dental make up is different, along with bodily chemical make up; indeed, what may work for you, may not work for me. What may last in your mouth, may not last in mine, and vice-versa.

So, if your crown work didn't last as long as it was estimated to last, it may very well be within your own mouth, and your own chemical make up that is causing the problem. Also, from your post, it would seem that if your insurance had covered the latest round of dental work, you wouldn't be complaining.

I would suggest that you sign the agreement for payment, before he sends your account to collections.

That's my take on this issue.

IAAL



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By reading the “Response” to your question or comment, you agree that: The opinions expressed herein by "I AM ALWAYS LIABLE" are designed to provide educational information only and are not intended to, nor do they, offer legal advice. Opinions expressed to you in this site are not intended to, nor does it, create an attorney-client relationship, nor does it constitute legal advice to any person reviewing such information. No electronic communication with "I AM ALWAYS LIABLE," on its own, will generate an attorney-client relationship, nor will it be considered an attorney-client privileged communication. You further agree that you will obtain your own attorney's advice and counsel for your questions responded to herein by "I AM ALWAYS LIABLE."

 
M

macksmom

Guest
Not EXACTLY what I wanted to hear, but what I needed to know. Thank you very very much, I appreciate your time and effort to help me!!

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Linda
 

I AM ALWAYS LIABLE

Senior Member
<BLOCKQUOTE><font size="1" face="Arial, Helvetica, Verdana">quote:</font><HR>Originally posted by macksmom:
Not EXACTLY what I wanted to hear, but what I needed to know. Thank you very very much, I appreciate your time and effort to help me!!

<HR></BLOCKQUOTE>

My response:

Thanks, and you're welcome. I know, and realize that sometimes law is a drag, especially when you have to give information that a writer didn't expect, or didn't want to read. But, such is life in the "big city."

Regards,

IAAL



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By reading the “Response” to your question or comment, you agree that: The opinions expressed herein by "I AM ALWAYS LIABLE" are designed to provide educational information only and are not intended to, nor do they, offer legal advice. Opinions expressed to you in this site are not intended to, nor does it, create an attorney-client relationship, nor does it constitute legal advice to any person reviewing such information. No electronic communication with "I AM ALWAYS LIABLE," on its own, will generate an attorney-client relationship, nor will it be considered an attorney-client privileged communication. You further agree that you will obtain your own attorney's advice and counsel for your questions responded to herein by "I AM ALWAYS LIABLE."

 
M

macksmom

Guest
Even in a small midwestern town!

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Linda
 

I AM ALWAYS LIABLE

Senior Member
<BLOCKQUOTE><font size="1" face="Arial, Helvetica, Verdana">quote:</font><HR>Originally posted by macksmom:
Even in a small midwestern town!

<HR></BLOCKQUOTE>

My response:

If it's any consolation to you, my wife is going in today, as it happens, for crown replacement. Here in Los Angeles, the same work as you're having costs $750.00. So, at least you're not paying as much. I know, big deal! I realize the cost of living is different, and still, $350 - $400 is nothing to sneaze at. For some folks, it may as well be $3,500 - $4,000. But, such is life.

Now, go brush your teeth.

IAAL




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By reading the “Response” to your question or comment, you agree that: The opinions expressed herein by "I AM ALWAYS LIABLE" are designed to provide educational information only and are not intended to, nor do they, offer legal advice. Opinions expressed to you in this site are not intended to, nor does it, create an attorney-client relationship, nor does it constitute legal advice to any person reviewing such information. No electronic communication with "I AM ALWAYS LIABLE," on its own, will generate an attorney-client relationship, nor will it be considered an attorney-client privileged communication. You further agree that you will obtain your own attorney's advice and counsel for your questions responded to herein by "I AM ALWAYS LIABLE."

 

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