Orthodontists change total fee

[DaisyDoesDallas]

wait, you are complaing because it is costing you less?

Yes and no!

[joes01bullitt]

wait, you are complaing because it is costing you less?

That's what i was thinking....if its costing you less live with it and move on.

[juiceweezl]

I have to disagree with you, the $5750 was the price quoted before they even made contact with the original insurance company to see how much insurance would cover.

Maybe they're charging you the extra for paperwork. Just freakin' move on.

[Forever_frost]

I get that part, I understand that the dentist can charge $50k for the procedure but insurance is only going to pay $1k. Totally understand that. Maybe this will help explain what I am not understanding.


In the original contract, which I am going to look to see if it says they can change the fee at anytime:

5,750 total procedure fee
350 insurance pays
5,400 out of pocket expense

11 months later, insurance policy is changed
6,835 total procedure fee
3,200 insurance pays
3,635 out of pocket

How can they go back and change the total procedure fee in the contract now that insurance is paying them more? They billed insurance the same $5,750 as they did in the very begining?

It's been 11 months. I can see how they'd go up

[Treasure Chest]

I get that part, I understand that the dentist can charge $50k for the procedure but insurance is only going to pay $1k. Totally understand that. Maybe this will help explain what I am not understanding.


In the original contract, which I am going to look to see if it says they can change the fee at anytime:

5,750 total procedure fee
350 insurance pays
5,400 out of pocket expense

11 months later, insurance policy is changed
6,835 total procedure fee
3,200 insurance pays
3,635 out of pocket

How can they go back and change the total procedure fee in the contract now that insurance is paying them more? They billed insurance the same $5,750 as they did in the very begining?

It has to do with what each insurance company sets as 'reasonable and customary' and their 'in-network' and 'out-of-network' rates.

Your doctor's office has to bill this way. Just because they're requesting that much from insurance up front doesn't necessarily mean this is what will be finalized on your explanation of benefits.