Correction: Blue Cross Blue Shield of Illinois didn’t rip us off at the dentist. They “forgot” to send payment.
A while back, I got a bill in the mail for ~$1,600 for some dental work we had already paid for.
At the time, Blue Cross Blue Shield of Illinois was making it very difficult to read the Explanation of Benefits and I posted in confusion about what was going on.
It seems that they did “approve” payment of my spouse’s dental bills, but then never actually deposited the approved payment amount into the dentist’s bank account, which triggered the bill which threatened to send us to collections.
I worked with the dentist’s office and BCBS of Illinois and was able to get BCBS of Illinois to send a paper check to the dentist in the mail, and now we have an account credit of $142 for his next visit, instead of an amount due. But I’m annoyed that whenever insurance makes an “error”, it’s never in your favor. Notice that? Notice how they made an “error” that would have kept $1,800 in the pockets of BCBS had I not pounced on it right away?
Insurance just makes everything confusing and impossible to figure out what’s really going on. And if they do something like this and you don’t really do anything about it, sure the dentist will be happy to take your money for something your insurance ought to have issued them a check for.
As the police interrogation tactics show, all you have to do is get mean with someone and start making threats, and most of the time they back down, even when they’re right. They start saying and doing things that are not in their interest, which they know are wrong. Because someone got mean with them. In this case, the insurance company stiffs you, the dentist threatens to send you to collections. Many people probably just send them the money.
I think that in the last 5 years, I must have filed appeals forms for health and dental claims at least 5 or 6 times, totaling several thousand dollars. And what usually happens is, yes they should have paid, but didn’t. And then they start blaming “the computer” or something.
Then by the time you get it sorted out, sometimes you’re already in collections and have to send proof your insurance finally did pay the claim to credit bureaus to repair damage to your credit reports.
I have no dental insurance at all. I get by on $15 cleanings, and have been lucky enough to have not needed a filling since 2007. Last time I was in for a cleaning, I let a student seal all of my teeth that the dentist said were most likely to develop cavities in the future, and they did like 9 of them, and hopefully that will forestall any serious repair work for at least another ten years.
Which is good, since my spouse is from the Philippines and has never had access to good dental care until he came here. And I’m spending beaucoup bucks even with his insurance, and fighting mishandled claims, to try to play damage control.
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