<p>Last spring, DH had a crown done. At the time, he was charged and paid for two crowns. I assumed that he’d had two crowns done. I usually submit medical and dental reimbursements once or twice a year, usually at the end. I submitted this claim to our dental insurance company, and they rejected one crown, saying they needed additional information (they always say this, and the dentist has always sent it quickly in the past). They rejected the other crown, saying that they’d already paid a claim for this crown the previous year. I called the dentist’s office, and spoke to the person I always speak to. She called me back, apologizing, saying that they had charged again for the earlier crown. She said that the dentist was out of town, but that he would send a check the following week. She also said that she would send the insurance company the information they needed, and asked me to email the EOB. I did so; this was in early February.</p>
<p>Two weeks later, no check from the dentist, and no new information online with the insurance company. I called again, and she said that the check was about to go out, and promised to take care of the insurance information. She asked me to fax her the EOB, so I did so, providing it for the second time. I emphasized that I needed this done right away, so that the claim would go through the insurance company in time for me to submit the balance to my flexible spending account, with a looming deadline.</p>
<p>Two and a half weeks later, the insurance company has received nothing, we have not received the dentist’s check. I have a call into the woman (who seems to always be at lunch when I call, any time of day), and I will let her have it when she calls back. But what can I do if they don’t come through?</p>
<p>This is a total of $4,000. $2k for the refund on the double-charged crown, and $2k in insurance reimbursement+fsa reimbursement for the other one.</p>
<p>From expericence, I can tell you that insurance paperwork takes forever…way longer than anyone should expect it to. I am NOT a patient person, but I have learned that with dr. and insurance billing, one has to be very, very patient.</p>
<p>My advice is to NOT “let her have it”. Politeness goes a long way, and once you ruffle feathers it is very hard to get back in good graces, especially if you are depending on this person for help. Also, if you are able to, you may want to go to the dental office and speak with them in person…with necessary forms in hard.</p>
<p>Good advice about not letting her have it - I am always very polite and understanding, but I am angry now. I’ll control myself, but will be firm.</p>
<p>I would agree, politeness, perhaps one more time.
If it were me, I’d also mention how disappointed I was, first in the double charge, but even more so with the delay to correct the error. Then I’d remind them of the looming
deadline on the FSA and say if their delay correcting their error ends up costing you extra money, then naturally you will expect reimbursement for those costs too.</p>
<p>Can you believe she didn’t call me back? I finally called again just now. She was quite casual about the whole thing, she’s been busy, it’s on her desk, etc. I finally extracted a promise that everything would go out tomorrow.</p>
<p>If you don’t get it, I’d stop by the office or call and ask to speak with the dentist and not the employee. Keep everything (conversations/dates/person you speak with) in your records, just in case.</p>
<p>If this is not resolved tomorrow, I’d call and ask to speak with the practice manager. In fact, even if it is resolved, I’d request to speak to them. I can almost guarantee you that the dentist has no idea any of this is going on. The last thing the dentist wants is negative patient issues that have to deal with billing. So if there is no practice manager, I’d write the dentist directly.</p>
<p>I thought of writing to the dentist, but assumed that the office staff would intercept the letter. You are probably right that the dentist has no idea this is going on. It’s actually two dentists, Madison Ave, NYC, very fancy practice. The whole thing is so weird that I started to worry that maybe they were going out of business.</p>
<p>One time when I had a major complaint against our daughter’s pediatric pulmonologist’s office, I wrote him directly and on the outside of the envelope, wrote Personal and Confidential. </p>
<p>I’m pretty certain that handling it this way, avoiding any office staff from intercepting it, is what spurned such a quick reply from the practice manager. This was the last thing the physician wanted to be dealing with and I’m sure was none too happy about hearing what happened, thus the quick reply once he got it in the right hands.</p>