Can dentists charge as much as they want above Insurance cost for the service provided?

Question

Details: dentist is an HMO provider and Insurance pays amount specified on their policy. Is there a limit of how much can dentist charge above Insurance limits?
Thanks

Answer 1

If the dentist is an HMO provider, he/she generally has an agreement as to specific charges over and above HMO payment that is allowed. Contact your HMO to see if this applies in your coverage.

Answer 2

The insurance amount is what the dentist contracted with the insurance company to pay. All insurance companies pay different amounts.The insured person will never pay the difference in price. All they are required to pay if they have any out of pocket expenses is the contracted amount. That is the benefit of insurance.

I don't know for sure if there is a limit on how much a dentist can charge above insurance limits. Only an uninsured person would have to pay the full price. If the uninsured person feels the amount is too much then they have the luxury of shopping around. They are not stuck staying with a preferred provider.

Answer 3

A dentist can charge as much as the traffic will bare. Your insurance pays a set amount you pay the overage. Make sure your dentist is "in network" then charges will be somewhat more reasonable. Your dentists charges are up front, if you don't like them look around for one who charges closer to what you like. This is a question you should take up with your insurance.

Answer 4

dmo has a set rate, but for a ppo dentist you would have to pay a percentage (coinsurance). The worst part about dentists are that they like to provide uncovered services.

Answer 5

cost are cataloged like as in auto repairs but the guidelines
are outrageous to . and some dentists refuse to fill a small cavity and wait till they grow into big expensive ones replete with root canal and crown don't trust anyone these days