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I took my two daughters for a “Free Consultation” to an Orthodontist. They said the doctor may need to take x-rays, Panoramics. These are not included in free consultation.

I checked with my insurance company before I go to make sure I know what I can get done. I thought I had everything covered.

We go to the Free Consultation visit, get the Panoramics, dentist checks their teeth. He tells me both my daughters need spacers and night guards. The ortho office said I have to wait for insurance. Not sure why they couldn’t tell a price. They dance around saying we have to wait for insurance.

A month later I get information from insurance pretty much confirming what I knew. My daughters each gets covered for $3k a lifetime dental treatment. It also provides the Phase 1 treatment [spacers and guards] costs; almost the entire $3k per child.

The orthodontist office refuse to tell me an approx for Phase 2.

I am not sure I want to move forward without knowing the total cost. They can’t even give an Approx cost...say $2k to $5k would help. Without this info I decide not to proceed with them.

Four months later I get a bill for $165 per child from Dentist office. I was surprised as this was Free Consultation with insurance for anything extra panoramics, x-rays, etc.

I call the office and go back and forth with them over whether an x-Ray was taken. I believe it set the tone for them treating me like garbage.

I later realized; it didn’t matter whether an x-ray or a panoramic were done that day, they were both covered under my plan. What the dentist office charged me for is a “pre-orthodontic treatment” which is not. If I was moving forward the cost would have been lumped in with the spacers/night brace. I wasn’t moving forward so how can they charge me for pre-orthodontic when all I was told was I would have to cover the cost of those other items.

I get on a 3 way call with insurance, me and the ortho office manager to figure out coding on the bill. The lady at the office wanted no part of it. She felt attacked, went on a rampage about how awful I was. We hung up.

The insurance rep said she’s never seen such rude behavior. The insurance rep's supervisor is waiting for my approval to file a complaint against the office manager for rude behavior.

The ridiculous part is the x-rays and Panoramics are covered by my plan. I signed a contract saying I would be responsible for fees not paid for by my insurance. Thinking that I had done my homework and made sure it was covered.

The insurance says they just have to change the code, but they refuse. What can I do? I can’t hire a lawyer for a $330 bill.

closed as unclear what you're asking by BrenBarn, MD-Tech, Pete B., Nathan L, JoeTaxpayer Feb 14 '18 at 12:51

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    Most of your question seems to be a rambling narration of details that are not germane. Please try to cut it down to the pertinent information and foreground your actual question. – BrenBarn Feb 13 '18 at 8:31
  • Why not just not pay the bill and file the complaint? – Pete B. Feb 13 '18 at 11:56
  • Sorry for the rambling. It was 2am when I wrote it. If I pay there’s no way I’ll see the money again. If I file the complaint nothing really happens to them. The insurance company just calls them, says we have a complaint about your office staff, we’re putting you on a list of offices that treat customers bad and they give them my name. I don’t think they’ll care and my name will get thrown around as office fodder. Is there a way to dispute it while not being sent to collections? – Rob137 Feb 13 '18 at 12:27
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Realistically, if the bill is only $330, you're unlikely to find a solution that doesn't cost you more than that in time and irritation. I would just pay the $330, give them a one-star Yelp review, maybe file a complaint with the Better Business Bureau, tell anyone who asks that they're not to be trusted, and get on with your life.

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There are non legal avenues that you might consider.

Contact your state dental association. They have a peer review process to help resolve dental treatment disagreements. If it is a legitimate complaint, they will mediate.

States also have a Board of Dentistry which provide the ability to submit complaints.

You should make another attempt to resolve the issue with your dentist. If they do not address the situation, thank them for their time and before hanging up, politely inform them that you are filing a complaint via your insurance company as well as the two state entities that I mentioned. That might get their attention.

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I can’t hire a lawyer for a $330 bill.

Assuming calling the dentist regulators doesn't work, you still have options.

If I were you, I would concentrate on the option of filing for insurance payment under a different claim code. Check with the insurance company and have them explain that code X (pre-orthodontic) should be replaced with code Y (whatever that might be). Write the office with an actual letter where you state formally something like

Dear [office name],

As discussed on [date of phone call with insurance], you are billing [name of insurance company] improperly. You need to use code [Y] rather than code [X].

If you continue harassing me rather than billing the insurance properly, I will be forced to report you to the appropriate authorities for predatory collections activity.

Thank you for your prompt attention to this matter,
[Signature]
[Name]

It may or may not be helpful to list contact information for the insurance regulators, the local government attorney, and the Better Business Bureau in that letter. If you do list them, do so with an "including but not limited to" disclaimer.

Keep a copy of the letter.

Call your county or state attorney. I.e. the one that you already pay with your taxes. May be called a district attorney, states attorney, attorney general, or something else. They are the ones who handle predatory collections activity.

There is also the Better Business Bureau. When they receive a complaint, they send around a representative who hits the business up for money and explains how to get out of the current complaint (use a different billing code with the insurance). They are free and may help in that they are a dispassionate third party. You may want to make your complaint directly to the person who goes out to visit businesses. This is so that person knows to suggest not only that they stop promising free consultations if they are not providing them but that in this particular instance, they work with the insurance.

If that doesn't work, call your local news station. Almost all news stations have a "This is what can go wrong" program. After a day of a television reporter standing in their parking lot asking potential customers if they know that the office engages in predatory collections activity, they'll be highly incented to just bill the insurance properly. Then the TV station will say, the office has decided to bill the insurance properly rather than "Don't go to ... office. They refuse to bill the insurance and instead try to collect from you!"

  • The Better Business Bureau has no teeth whatsoever. If the accused chooses to ignore the BBB, there are no consequences other than a "They were naughty" notation in their file. – Bob Baerker Feb 13 '18 at 14:48
  • Thank you for all of this feedback. It’s helping me tremendously to know I do have options. I hate having to report anyone’s business, but it’s just so frustrating how they could care less about me. I’m feeling guilty hurting this man’s business and yet when I asked him to change the coding it was like too bad, so sad. – Rob137 Feb 13 '18 at 16:57

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