Florida Dental Insurance, How can you know if your dentist is over charging
Florida Dental Insurance, How can you know if your dentist is over charging: I am new to having dental insurance and really going to the dentist. Four months ago I got dental insurance though my job.
Since I have not been to the dentist is a long while I thought I would use the dental insurance I got and go. Preventive care was to be free at least that what I thought but I got a bill back from the dentist saying my insurance company did not pay 100 % of the billing.
So I called the insurance company and was told that the dentist charges where over their UCR fees. I asked what this meant and was told in short my dentist cost was too high. Does this means my dentist is over charging me? I do not want to have to pay for dental care when it was to be free.
Tuesday, Feb. 1st 2011 1:30 PM at 1:30 pm
One of the first things you should know is that a dentist has the right to charge whatever they want to for their services. That is why prices for dental services will very from dentist to dentist depending on where you choose to go.
I am guessing by what you stated in your coment that you have a dental PPO plan. You should be able to note in your plans terms and conditions that although their coverages may say they will pay out to a certin percent, it is still up to a UCR (usual, customary and reasonable) or Fair and Reasonable cost guild lines which are normally determined by the claims department.
As an example, if the dental company UCR on a basic cleaning in your area is $100 but you go to a dentist that charges $200 the likelyhood of you having a UCR fee is high. Do you still receive benefits towards the cleanings? Yes, but only up to the UCR
One good way of knowing if your dentist will be over the company UCR fees would be simply submitting all claims as a quote only prior to having any dental work started. That way when it comes back you will be able to deside if you wish to continue with the dental care or not.
If you do have a dental PPO plan try your best to stay within the company dental provider database. Choosing dentist in the plan network will normally keep you within the UCR rates therefore are are not hit with any additional UCR fees. (Though it is still a good idea to submit all claims for a quote to confirm this.)
So in short to say your dentist is over charging you and you should not have to pay the cost difference is wrong. You still need to pay the dentist the remaining cost. It is up to you to know how your dental insurance plan works. Being new to having dental insurance does not exclude you from having to pay any additional cost due. However learning from this will help you in the future to avoid any unexpected costs.