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What is Massachusetts Dental procedure or process when accepting new patients?

A couple of months ago, my boyfriend went to the Dentist to get his teeth clean. The Dentist said that he require a deep cleaning and the estimated cost of out of this pocket around $900. He applied for the CareCredit so he can make the payment monthly instead of the full amount. A month ago, he received a bill from CareCredit for the amount little more than $900. But, less than 2 weeks ago we also received a bill for $1340 from the dentist. I called the Dentist last week to really find out the reason why they are also billing him? The Dentist call me back today and stated that the cost of the novacaine are not covered by the insurance and the estimated cost that they provide is not the exact cost for the services. When I continue to questions that wouldn't it be ethical for the clinic to information the patient if the cost of what they estimated for an out of the pocket is now mutliplied by more than 100%, he when on stating that the Dental Insurance that my boyfriend have is not active. A few things doesn't fit and doesn't make sense to me at all: 1) Wasn't the Dental office suppose to verify the Dental Insurance and what the patient are qualify for before providing the services? 2) They have almost a week to verify this information, so how come when my boyfriend when for his appointment, why didn't they mention or questions my boyfriend regarding his dental insurance company wasn't able to locate my boyfriend information? 3) Why did he first brought up the point that the cost of the novacaine was covered by the insurance, and then move to the point that the dental insurance doesn't have my boyfriend on file and that he is not a member? Something really doesn't seem right to me. What is the procedure for the Dental Clinics to do when admitting new patient? I am planning on calling his Delta Dental tomorrow for him. But, if anyone out there who are able to answer my posted questions and have any advise on what I should look at to help eleminate this extra bill from the Dental office I would greatly appreciate. Thanks in advance, from the lost and confuse...

Public Comments

1. First of all, you need to call the insurance company first! Find out if he is still on the plan. If he is not, this is not the dentist office responsibility to call for you. Some offices do call for you as a courtesy and also to protect them. But they don't have to..... It is odd that he told you the cost of the novicaine wasn't covered. I don't understand that.....the only thing I can think of that would be close to that is that maybe he meant that they didn't cover that particular procedure since a regular cleaning is covered and doesn't require novicaine, not sure that's weird? I'm a dental hygienist and at my office we send out pre-determinations for deep cleanings to make sure they will be paid for before we do them, but again that is something we do for protection and knowledge but it doesn't have to be done. Maybe the insurance company just flat out denied the procedure because they thought it wasn't necessary? And by the way, 900 out of pocket to begin with is a lot! And that was with the insurance figured in??? At my office we charge 165 per quadrant. So 165 x 4. and then most insurances cover at least 50 to 80% of that. There are a lot of Delta dental plans, but the ones in ohio I know cover 80%. We also use care credit in my office. What happens is the dentist receives the money you borrowed right then and there like a credit card payment and then you pay care credit back. So they already have your 900 dollars and they want 1340 more?? WOW! Are you sure 1340 isn't the total owed? Please check into this. The first place to start is his insurance.