I needed the tooth extraction and bone graft done on two teeth. Prior to the service, dentist presented the estimate fees of $2,340 and noted that insurance would cover $264 for extraction but nothing for bone graft so patient responsibility would be $2,076.
Work was done and I paid $2,076 upfront with my HSA.
Two weeks later I received the EOB from the insurance and it stated the following:
Dentist submitted: $2,340
Negotiated fees: $1,012
Allowed amount: $1,012
Insurance paid $680.60
Patient responsibility $331.40
Insurance did appear to show negotiated fees for both extraction and bone graft so I read them as covered service. I’m unsure why the dentist claimed that bone graft would not be covered when they sent me the estimate.
Since I’m only responsible for $331.40 based on the EOB, will I be able to request for refund of$1,744.60 (=$2,076-$331.40) from my dentist? The dentist is in network.
Location: TX
Thank you in advance!
Yes. Definitely call the dentist.
Call your dentist and ask. It could be based on how it needed to be billed. My daughter just had aligners put in and the dentist said it’ll be $750 out of pocket. The EOB came home and it was confusing because it just showed $900 as cost and the amount I owed was very little. Call the dentist and they explained the total cost was $4,500 prior to insurance but since it’s for a 12 month service, they only charge and submit payments each month.
Thank you!
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