Is this ALSO the way your dental insurance works? Or does this sound like a scam?

I had a root canal, they said the price for that with my insurance would be $470.00 , which I was fine with. So I had it done and afterwards 3 secretaries working in the office said I had to pay before I left in full, before I signed the agreement they never said it had to be paid all in the same day. And they said that if I paid only a partial payment that dental insurance company would not pay for the rest of it and my insurance would be VOID if I didn't pay in full. Does anyone else's insurance require full co-payment or else your insurance is void and you'll owe thousands for whatever procedure you have if you choose to pay small amounts until you pay the balance?

Is this how all insurance works?

And also the same dental office that I mentioned above, said that if I didn't get my crown put on after root canal within 2-3 weeks that the insurance company would not pay for me have it because after 2-3 weeks the root canal would need to be redone? That part seems untrue because all other dentists I've spoken to said that the root canal would be fine even like a year later which is what happened with my other dentist he did my crown a year after a root canal because I am in college and it took a while to save the money for it. They said that my insurance won't pay for a root canal on the same tooth twice, and I'd have to pay out of pocket for the second root canal which they would deem as mandatory if I do not get a crown put on within 2-3 weeks of getting the root canal.

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  • 9 years ago
    Favorite Answer

    Since I often began by criticizing MBR Catz, this time I want to say that I agree.

    When I first read the question, I thought there was something fishy going on. RFTM convinced me that I was correct.

    If the dentist's office submits the bills to the insurance company promptly and you pay the copay eventually, then the insurance does pay its part.

    However, if you do not pay immediately and the dentist's office decides that it is too much paperwork to handle both the insurance claim and you paying over time, then the dentist's office might not submit the insurance claim, and that decision by the dentist's office could keep the insurance from paying.

    The comments about the impossibility of a second root canal are alarming. If the dentist's office is really threatening to make you pay for a treatment that is not possible to perform, then stop going to this dentist and find another.

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  • rtfm
    Lv 7
    9 years ago

    I can't comment on the insurance part of this, but I can certainly say that your dentist is BADLY mistaken about the root canal thing. There is NO WAY that a root canal needs to be "redone" or even possibly COULD be redone. When they do a root canal, they REMOVE THE ROOT from the tooth. It doesn't grow back again. There is NO SUCH THING as a second root canal on the same tooth!

    You get a temporary filling put over a root canal, and that covering stays there until you get the crown put on, whether that's two weeks later or several months. I've got a temporary filling over a root canal right now that's been in my mouth since August, because I am waiting for January to get it done because the dental insurance I have only pays a certain amount every calendar year. My dentist doesn't have a problem with me having the temp filling there for six months. My insurance company doesn't have a problem with me waiting six months between the root canal and the crown.

    The mistake you're making is letting your dentist tell you what your insurance will or won't pay. It is NOT THE DENTIST'S JOB to tell you what you're covered for. Only your insurance company can tell you for sure what they pay and under what circumstances. Call the insurance company yourself, tell them what the dentist said, and see if he was right.

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  • 9 years ago

    Not true, that the insurance won't pay unless you paid first.

    That's your DENTIST'S policy, not the insurance company.

    Many dental offices WILL require your share in full, on or before the work is done, in order to make sure they get paid. Most people won't think twice about stiffing the dentist AFTER the work is done.

    It's true that insurance won't pay for the same root canal twice . . . but it's ALSO true that the original dentist will have to fix the job for free, usually within a year, if it needs to be redone.

    I'm not a dentist, but I don't think you CAN do two root canals on one tooth. I think once you take the nerve from the root, it's GONE. So if it needs a second root canal . . . they didn't finish the job the first time.

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  • 9 years ago

    Your insurance company would not cover the crown if you dont do it around the time of the root canal because it would be considered a separate treatment. You dont redo a root canal, and therefore your insurance would not cover it if you left it for a year. You have only a temporary filling in your tooth after a root canal and you must get a crown as soon as possible, otherwise your temp filling can break and take more tooth with it, then you really will need a whole new procedure. Every dentist requires payment in full on day of treatment. Very few of them will take installment payments especialy on a small amount like $470. Dental insurance varies among companies.

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  • 9 years ago

    I can't answer the stuff about the root canal, but as far as payment goes... your payment to the dentist, and how that's arranged, is between you and the dentist. The insurance coverage is not affected by that, and the people in the office were b u l l s h i t t i n g you. Bullying you, in fact.

    When faced with that problem, just negotiate. Be nice, but be firm. In these hard times, dentists cannot afford to p i s s off their customers.

    One thing you SHOULD always do is ask your dentist to obtain preauthorization for anything major. Major means root canals, crowns, onlays, etc, going beyond your standard cleaning, xrays, and fillings. This way, you'll avoid the surprise when the insurance dentist disagrees with your dentist and says, no, you don't need an onlay, a simple filling would do nicely, and they pay $98 out of $1250, instead of $895. This is exactly what happened to me last month.

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  • 9 years ago

    Certainly sounds like some sort of administrative tangled mess.

    Contact an agent of your insurance company; see her in person if you can.

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  • Anonymous
    9 years ago

    Why don't you find out DIRECTLY from your insurer what you policy terms are?

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  • 9 years ago

    huh? Try again and this time explain properly.

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