I had to have an emergency root canal, and my dentist sent a referral to Hingham Endodontics,…read moreconveniently located next door. I was thankful they were able to get me in the very next day.
Unfortunately, the billing and overall experience left me extremely disappointed.
At the front desk, I was told that Hingham Endodontics accepts Delta Dental but that they are considered "out of network." I was also told that I had approximately $2,000 remaining in coverage for the year and that the root canal would essentially use all of it. I was then told I would need to pay $1,865.00 upfront and would receive a reimbursement check from Delta Dental within approximately two weeks.
When I received the check, it was only for $849.44.
I called the office and spoke with Jennifer to ask why the reimbursement was so much less than what I had been led to expect. At first, I was told the check was probably only for the consultation. She then explained that because the office is "out of network," Delta Dental would only pay up to 80%, but that the office is not told how much the insurance company will actually cover.
This was extremely frustrating because none of that was explained to me before I paid $1,865.00 upfront. I specifically questioned how the office could tell me that I had $2,000 remaining in coverage and that I would receive a reimbursement in approximately two weeks, while apparently not knowing how much Delta Dental would actually pay. When I explained that this was never communicated to me, Jennifer apologized and said, "I am sorry that it was not explained further to you."
I understand that the office does not control Delta Dental's reimbursement decisions. However, I do believe the patient should be clearly informed when the office cannot determine what the insurance company will actually reimburse--especially when the patient is being asked to pay nearly $2,000 upfront. Had I known there was a possibility that I would only receive $849.44 back, I would have approached the financial decision very differently.
Unfortunately, my concerns were not limited to billing.
I also did not have a particularly positive experience with the doctor. Before the procedure, I specifically requested dental anesthetic without epinephrine, as I have had all of my dental work done without it due to how long I personally experience the effects of epinephrine. Initially, my request was dismissed, and I was told that I would feel the procedure without it. I explained that I have routinely had dental work performed without epinephrine and was comfortable proceeding that way. Eventually, my wishes were respected and the procedure was completed without epinephrine.
I am grateful that they were able to accommodate my emergency root canal appointment so quickly. However, between the lack of clarity surrounding the out-of-network insurance coverage, the unexpected reimbursement of only $849.44 after paying $1,865.00 upfront, and my experience having to advocate for a specific request regarding anesthesia, I left feeling that the overall experience could have been handled much better.
My biggest advice to anyone considering this office: if you have Delta Dental or any other insurance and they are considered out of network, do not rely on the office's estimate of what you will receive back. Contact your insurance company directly and get a clear explanation of your expected reimbursement and out-of-pocket cost before paying upfront.
