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Duplicate Billing

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Murdock_719

Junior Member
What is the name of your state? WV

Last year we started seeing a new dentist, he offered to fix my husbands front tooth (a little over half of it broke off when he was young), we said no it was fine that we didn't want work done that the insurance wouldn't pay for. They said no problem the insurance would cover it, so six months ago they busted out his front tooth and put a new one in.

We paid our normal 20% ($89) and they billed the insurance $228. The insurance company paid $136 on the bill and said that the rest of the claim was invalid because it was a duplicate billing. I asked the billing agent at the dentist what the problem was and she said they would rebill the insurance company. She said that she would have to bill it differently because many companies use different lingo for charges. I asked if I needed to pay the other $92 she said no they would rebill the insurance. They have rebilled the insurance about five times now, they deny it each time again saying it is a duplicate bill.

I called the insurance company and they informed me that the dentist was billing for more surfaces than the tooth contains, I asked them if I would be responsible for the amount not paid and they said no because they had already paid and it was a duplicate billing. I called the dentist back and she said she would rebill that they hadn't properly understood. She has tried billing them several more times only to receive the same denial that it is a duplicate billing. The dentist called me saying I had to pay the $92 left over. I said I wasnt' sure why as the company didn't say it wasn't a covered expense but a duplicate expense. If it is a valid bill I don't mind paying it but don't want to pay for something the insurance company has already paid.

I am unsure of what is going on whether they were trying to pull one over on me or the insurance company. I question it because this tooth has only cost us around $150 to replace a few years ago (they have already been paid $225 for this one tooth). We have already switched dentists as we were weary of the billing practice. They are saying they are going to turn the bill over to a collection agency -- so I am wondering what I need to do.
 



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