Dental insurance question....

[starryfish]

Ok so I havent had any major dental work done before this as an adult. My DH and I both had to get crowns last year so I got Dental insurance (our regular health plan covers 2x a year dental apts). 

i distrust the dental office we had the work done at because I got 4 different $ quotes for the same work....

Anyways...here is my problem/question:

Basic filling:They charged my insurance $155. My insurance allows $86. insurance paid $69 and said I own $17. Dental office is saying I owe the remaining balance of $69 plus the $17. 
Crown: They charged my insurance $1320. Insurance Allowed $1027. Insurance paid $528, says we owe $499. Dental office says I owe the $499 plus the difference in what insurance paid/allowed, so an extra $293. 

Is this right? Can they "charge" me for the difference between what Insurance says they pay and what they billed them? Does that  make sense? I thought insurance companies (like health ones) pay a "discounted" rate usually. I have never had to pay the difference before. 

ETA: I called my dental insurance and they said they were in network and not allowed to collect any more than the negotiated amount. If they WERE out of network they could. 

[holly22]

I don’t think so, they should only bill your portion and the off the other. They typically have a contractual obligation to do this based upon their contract with your dental insurance company.

[Jalapeñomel]

What they pay insurance is not what they charge patients normally.

Maybe ask sent she’s our dental genius! 🦷

[flygirl]

That’s a shady dental office.

[sometimesrunner]

It might depend on whether your office is in or out of network? Maybe?

[gingery]

Depends on if your dentist is in network or not. It out of network they can balance bill up to the submitted charge.

[starryfish]

They were in network, so I think the answer is no they can’t charge me extra

[gingery]

They shouldn’t be able to balance bill you. Considering they’ve had some quoting issues I’d bring it up with them. You can also call the insurance customer service number and complain, their fraud/abuse department can handle it with them as contractually they can’t bill you.

[sent]

Your insurance company is right. The only way I can think of the office being right is if they have multiple providers and one is in network and the other one is out of network. And you were seen by the out of network doctor. Your EOB should say if the doctor is in or out. They love notifying subscribers when doctors are costing them more money (they sometimes pay out of network dentists more than in network ones and obviously they don’t like that).

[yentl]

This is called balance billing and it's insurance fraud. Your dental office is shady as fuck and you shouldn't go back there. I would be wondering if you even needed that work done at this point.