Where is the chart that says what insurance companies call "reasonable and customary" and why is that SO FAR off from what dentists charge? This is all over the workplace at multiple companies.
2007-05-30 06:57:12 · 7 answers · asked by ninety9point8 4 in Health ➔ Dental
reasonable and customary is what the insurance companies will pay, that is all. It is NOT reasonable, but it most certainly is customary, insurance companies are not in business for your benefit, they are in it for a profit and that is all that matters to them. Until people simply flat refuse to use insurance companies, they will continue to extort all the money they can get.
2007-05-30 07:01:40 · answer #1 · answered by essentiallysolo 7 · 0⤊ 0⤋
HELLO,
WHAT USUAL AND CUSTOMARY MEANS IS THE CHARGES TO THE PATIENTS WITHIN THE AREA WHERE THE DENTIST PRACTICES. THIS WAS A FIGURE THOUGHT OUT BY THE INSURANCE COMPANIES. THEY WANT TO PAY THE LEAST AMOUNT POSSIBLE, SO THAT THIS DOES NOT REFLECT THE TRUE COST OF THE SERVICE BY THE DENTIST THAT IS ALWAYS HIGHER. THIS IS NOT POSTED AT THE WORKPLACE, BUT BY CALLING THE INSURANCE AND ASKING WHAT THEY WOULD PAY FOR THE PARTICULAR SERVICE. THE CO-PAY IS THE DIFFERENCE THAT THE INSURANCE DOES NOT PAY FOR WHICH THE PATIENT IS RESPONSIBLE. DIFFERENT INSURANCE OFFERS A DIFFERENT STANDARD OF BENEFITS.
2007-05-30 08:26:00 · answer #2 · answered by Dr. Albert, DDS, (USA) 7 · 0⤊ 0⤋
Insurance companies take a "fee survey" including low-end dental clinics. They then take an average of those fees and come up with an arbirary R & C fee list.
Insurance companies need to pay out the least amount possible under their contracts in order to make a profit. Their so-called "reasonable and cusomary" has nothing to do with real-world quality dentistry.
2007-05-30 07:07:59 · answer #3 · answered by emmalue 5 · 1⤊ 0⤋
Reasonable is usually cleanings up to a certain fee and other basic dental work. You have to call the insurance company (or have the office do it) BEFORE any work is done to find out how much it will cover.
2007-05-30 16:15:40 · answer #4 · answered by Educated 7 · 0⤊ 0⤋
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2016-11-23 18:27:53 · answer #5 · answered by Anonymous · 0⤊ 0⤋
The size of the bill and the lasting of the workmanship. Which may depend on you and the size of the waiting room and the skill of the executioner.
2007-05-30 07:08:42 · answer #6 · answered by RT 6 · 0⤊ 3⤋
i think they are evil rip-offs....
2007-05-30 07:03:51 · answer #7 · answered by Daniel F 6 · 0⤊ 0⤋