When you think of doctors and dentists, you probably think of yourself as a patient, not a customer. In reality, you are both. Just as you would at a grocery or department store, it is fair to expect good customer service from your medical providers. This includes the providers’ office staff and billing departments. Being diligent in reviewing bills from your doctor or dentist can save you money.
I recently received a bill from my dentist for $54 that did not reflect any payments from my insurance company. The bill included a note that said the claim had been rejected by the insurance company. When I called the dentist’s office and asked why the claim was rejected, the office representative said she couldn’t tell from the documentation she had.
In checking my records, I found no explanation of benefits from my insurance company for that office visit–that’s the form the company sends that shows the treatment you received, how much your insurance coverage paid on the claim and how much you still owe. When I called the company, I found out they’d never received a claim from my dentist’s office for the date in question. So I called the dentist’s office back, relayed this information and asked the staff to file the claim again.
Today, the results arrived in the mail, in the form of an explanation of benefits (EOB) statement from my dental insurer. The company paid most of the claim, and I only owe about $11. That means I saved $33 over what I would have paid if I had not been persistent enough to find out whether my claim was actually filed and to make sure it got submitted.
When it comes to claims and billing, don’t take the word of your doctor’s office staff without verifying the facts for yourself. Use your EOB statement to make sure you don’t overpay for medical and dental services. If a claim truly is denied, ask the insurer’s customer service staff how you can appeal the decision.
Have you had a successful experience in fighting an insurance claim denial? Share your tips to help others.