Legal Question in Insurance Law in Indiana

Dentist charged when Insurance should cover

I went to the dentinst in February 09 for some jaw pain. I found the dentist on my preferred providers website and the dentist said I was covered. I went over a month later for a cleaning, which they again agreed that my insurance would cover me. I received a bill at the beginning of June saying that insurance would not pay and I owe the over $200 from both appointments. Is it legal for a dentist to tell a client that they are covered by their insurance and then charge them for all the work? Should the dentist office take the cut for the mistake? If so, how would I go about having them write off the charges and what can I do at this point?


Asked on 6/09/09, 11:54 am

1 Answer from Attorneys
Larry Jackson Jackson Law Firm, LLC

Re: Dentist charged when Insurance should cover

Typically the consents we sign at dentist offices and other medical providers' offices say we are responsible for anything not covered by insurance. These contracts are typically upheld in a court. Therefore, at the end of the day, the dentist can most probably require you to pay. I would ask the dentist to speak with him about the issue and let him know you were assured by his office that the appointments would be covered and now you are being told that they aren't. Ask him to help you determine why your insurer is not covering it and what can be done about it. Perhaps the insurer has made a mistake. Perahps his office did. If there is in fact no coverage, ask him to charge you what the insurer would have paid rather than the full billed price. Ask him to allow you to make the payments in weekly or monthly increments that is bearable to your budget. Larry

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Answered on 6/09/09, 1:19 pm


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