Military community please read this if you have United Concordia for insurance!!!!
I went in about a year ago for a simple checkup and to discuss a broken tooth. During the appointment, I specifically explained that my insurance would likely deny X-rays because I had already had them done less than a year earlier. They told me they would still run everything through insurance and, if it wasn't covered, they would honor a new patient special rate.
At no point were X-ray costs discussed. When I checked out, I paid around $1,000 for the crown and buildup. No one mentioned owing anything additional for X-rays.
They also recommended a deep cleaning that would cost about $800 for the first round. When I later asked if we could remove services insurance wouldn't cover, I was told no because it was part of their "standard of care." I couldn't afford the extra treatment, so I didn't return.
About a year later, the crown started irritating my gums and the tooth began throbbing. When I went back, I was told I needed a root canal and that I should have done the deep cleaning.
I requested a predetermination, left, and switched dentists.
A few months later, my insurance reviewed the claims and determined I had been overcharged based on the crown codes used. They issued a refund, and I thought the situation was resolved.
Then I received a letter stating I owed $260 on the same account, marked over 90 days past due and sent to internal collections. After my husband spent time sorting things out with insurance, the office manager of Nut Tree told me that I had never paid for my X-rays and that, because of that, she technically should not have issued the refund I received. She said I could keep the refund, but the $260 balance would still stand.
The voicemail only added to the confusion because the X-rays were never presented as an outstanding balance when I paid for treatment. As far as I knew, my account had been settled based on the amount I was charged at checkout. It wasn't until the insurance issues were being reviewed later that the unpaid X-rays were even brought up.
What makes this even more frustrating is that I specifically raised concerns about insurance coverage before the X-rays were taken. Looking back, I later discovered that financial responsibility language was included within the exam consent paperwork, but there was never a clear discussion that I could end up personally responsible for hundreds of dollars if those X-rays were denied.
I tried calling multiple times and never got a response. The moment I put everything in writing via email, I got a quick reply and a much friendlier tone. At that point, I agreed to pay because I was exhausted by the stress. I'm pregnant, and I did not have the emotional fight to keep going over something that never should have escalated like this. Furthermore, this company wants feedback to be better per responses to reviews but I can't even get the office manager on the phone to talk about my experience.
My advice: get EVERYTHING in writing. Read everything. Get everything; pricing/payments/insurance coverage amounts on every service before doing the service. Do not sign anything you don't fully understand, Don't trust their word because they won't honor it unless on paper. And if they are pushing services that don't feel right or don't fit your situation, walk out. (I wish I would've).
Because at the end of the day, it really felt like it was never about you or your care. This company is all about money. read more