My dentist wants me to pay up front and have my insurance company reimburse ME?

Question

I just went to the dentist today and had a filling. I have dental insurance, but the dentist wanted payment up front for the services.

The receptionist said they require payment in full for the services on the day of service, and then they will send the insurance claim in to the company and eventually I will receive a reimbursement check.

Isn't that what INSURANCE IS FOR??? So you DON'T have to pay?????

I don't handle the cash in my family, so after much arguing about requiring payment up front, the receptionist agreed to let me walk out withouth paying, but expects me to have my husband pay by tomorrow.

It just doesn't seem right that the dentist gets cash up front for the work, and then makes ME wait to get reimbursed by the insurance company... what the heck?

..the recep. said this is their "POLICY" and everyone has to do it.

(I didn't have insurance before this so I just always paid up front, so this is my first experience with insurance at this office)

The insurance is BLUE CROSS, the largest insurer besides the govt in this country.

Answer 1

If your dentist is not a "Participating Provider" the insurance check from Blue Cross Blue Shield is automatically sent to the subscriber. Most offices work similar to what your dentist does, but usually they require 50% down and the remaining balance at the time of insertion or completion. The insurance cannot be submitted until the work is complete and Blue Cross Blue Shield usually pays within 7 days. They are one of the fastest insurance payors I have ever dealt with. They will not pay for all your procedures at 100% though, so you won't receive a check reimbursing you the entire cost and they usually have a $1500.00 calendar year maximum.
Dental insurance is not medical insurance so most offices are similar to the one you are going to. Some offices have these policies because patients have taken the insurance money and never paid for the services rendered. People don't realize how far they are asking their dentist to trust them. In our office if you are an established patient for a couple of years we will allow payment plans, but they are usually only 3-6 months out, anything longer and people tend to forget to pay us and then we end up sending the account to collection.

Answer 2

I would recommend you to try this site where you can get quotes from the best companies: http://cheap-insure.info/index.html?src=2YAhrxmfFD58

RE :My dentist wants me to pay up front and have my insurance company reimburse ME?
I just went to the dentist today and had a filling. I have dental insurance, but the dentist wanted payment up front for the services.

The receptionist said they require payment in full for the services on the day of service, and then they will send the insurance claim in to the company and eventually I will receive a reimbursement check.

Isn't that what INSURANCE IS FOR??? So you DON'T have to pay?????

I don't handle the cash in my family, so after much arguing about requiring payment up front, the receptionist agreed to let me walk out withouth paying, but expects me to have my husband pay by tomorrow.

It just doesn't seem right that the dentist gets cash up front for the work, and then makes ME wait to get reimbursed by the insurance company... what the heck?
Update: ..the recep. said this is their "POLICY" and everyone has to do it.

(I didn't have insurance before this so I just always paid up front, so this is my first experience with insurance at this office)
Update 2: The insurance is BLUE CROSS, the largest insurer besides the govt in this country.
Follow 49 answers

Answer 3

Don t compare dental work to buying groceries, not the same. People are accustomed to the idea that with insurance, medical procedures are billed after full tally of services and goods used in session, and apply that idea to dental procedures when using insurance. People think, I ve paid into insurance, why am I asked to pay out of pocket (besides a copay) with the dental industry? Will the dental office reimburse if they don t have to do all of a procedure, will they bill again for more service/goods used, is there price gauging if paying up front versus insurance adjustments? It s a messed up industry, the healthcare business. What it costs to set up a practice, what it costs to receive services from, and the real cash makers are those in the insurance, pharmaceutical, equipment / business side.

Answer 4

This practice is totally honest. The dental office where I used to work was not a Blue Cross preferred provider, meaning we were not in their network. We could file patient's claims for them, but blue cross would not pay us directly,they would send the check to the patient. Some patients were getting their dental work done then keeping the money that came to them in the mail. The patients were actually making money,not us! We could not trust that patients would bring in the checks blue cross sent them ESPECIALLY FIRST TIME PATIENTS. That may be what's going on here, nothing against you personally, the dr may have been burned in the past and asking for payment up front is the only way they KNOW they will be paid. You will be reimbursed by your insurance.

Answer 5

There are a lot of dentists who are choosing to go this route..if you call any random dentist and ask about insurance they will tell you that they bill your insurance as a courtesy to you, but ultimately you are responsible for paying for services rendered if your insurance does not pay. Insurance payments take a minimum of 2 weeks on up. I, personally, have sat on the phone with the insurance companies to try to get them to pay our office for services rendered months ago. Insurance companies can and have been a huge headache for dentists and doctors. Anywhere you go where they provide you with service..payment is expected at time of service. So why would this surprise you? For the dentist offices that choose to run their offices this way is not a bad thing. The dentists don't want their front staff to be on the phone all day trying to chase payments, that's not what they pay us for. It may not be good for you as a patient to pay for all the treatment out-of-pocket, but you are advised of the costs before you come in for treatment. You're lucky that they will send the claim in for you, most "fee for service" offices hand the filled out claim to the patient and let them deal with sending it in. Insurance is not there so that you don't have to pay for anything. It is meant to offset your out-of-pocket expenses, that's all.

Answer 6

I don't know as much about how this works for dental insurance as i do for medical. It's what is called Not Accepting Assignment which basically means the provider doesn't want to deal with the insurance, they might fill out the claim for you but after that it's your problem.

This is only allowed for out of network providers on a PPO type plan. Your best option is to call you insurance company, find out if this dentist is in network. If not find one who is, for this specific bill, if you can afford it pay it and be done. If not file your claim wait till you get the check from the insurance company and then pay it. The dentist office can't do anything to you but send you bills for the first month or so anyway.


If they are in network then they're really jerking you around and your insurance company does some leverage with them to make them accept the insurance.

Answer 7

Unfortunately, many insurance companies will nit pick with the doctor or dentist over valid charges. They do not have the manpower to have a full time person deal with these issues...if they did, your rates (and mine) at the office would go up to cover the pay for that person or persons, whichever the case may be. Your insurance company is probably known for not paying up properly and in a timely manner.

They will let you send the claim and if the insurance company wants to be poopy about things, then YOU deal with it.


You ARE still insured, you just don't get the money up front and this is becoming more and more common as insurance companies think of new ways to bilk doctors and patients.


Sorry. Welcome to the US health care system.

The people you need to be upset with are the ones at the insurance company, not the doctor/dentist.

This is rather common, I am surprised you haven't run into it before.....

Answer 8

I have heard of this. My dentist has a sign up front that says something about payment up front even with insurance but they never collected money from ME and I have insurance. It probably depends on the insurance you have and the office you visit.

The best thing to do is call your insurance company BEFORE your husband pays them to make sure you will be reimbursed and HOW & WHEN this will happen.

Answer 9

A lot of dentists and doctors are doing that now...they are tired of waiting for the insurance to pay...so they want there payment in full, it is stated on the desk, door, wall....whatever...See someone else if you do not like to do this...sad thing is this is the way they are trying to go, some insurance companies do not pay a bill for 6 months...and that is why they are fed up with them...It's no big deal if you pay up front or not, you will get reimbursed, after you fill out your paperwork as well of course...

Answer 10

dentist pay front insurance company reimburse