I made a dentist appointment 10 days early and I’m being charged.

[u/SmartererererChild]

I made my son his dental appointment in January, and then in July I called and made him his 6 month appointment. Insurance is saying the appointment was 10 days before the full 6 months and there is nothing they can do but charge me. What are my options? Would my dental office change the dates in the system? I don’t like that dentist and am planning on changing anyway. What are repercussions if I don’t pay.

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[u/Berchanhimez]

If you don’t pay the dental office can pursue you for it, up to sending it to collections and potentially reporting it on your credit. Whether they will do one or both of those depends in part on the amount. But ultimately it’s your responsibility to not schedule something that you are too early to get it done - not theirs.

No, they are not going to change the dates just because you messed up and scheduled it early. That would be fraud.

[u/husky5050]

The dentist will not commit insurance fraud on your behalf. If they do, maybe you could share a cell in prison.

[u/ProfessionalYam3119 → u/husky5050]

Conspiracy is a very serious crime.

[u/SmartererererChild → u/husky5050]

That makes sense - the dental practice also billed the insurance company for services I did not receive so maybe they are headed there anyway. I made sure to let the insurance company know

[u/ProfessionalYam3119 → u/SmartererererChild]

What services were they?

[u/Proud_Trainer_1234]

Your problem. You need to know the specifics and limitations your coverage. Some plans pay for two preventative appointments ( cleaning and x-rays ) any time within the 12 month scope. Others limit it to 6 months to the DAY. Asking the provider to falsify dates of service is illegal for him.( insurance fraud that could lose him his license) and unconscionable ask on your part. And, coming from a Dental Family, any patient that asked us to commit fraud, would be immediately dismissed from the practice. They aren't worth the risk vs return.

You owe the Dentist.If you don't pay, your account will be sent to collection and you will need to source a new Dentist

[u/DomesticPlantLover]

You don't really have a lot of options here. I don't mean to sound like I'm blaming you, but, legally, it is your job to know and keep up with that stuff. Not the insurance company, not the dentist's office. I know it seems it should be their job, and may do try to, but ultimately it's the patient's job to keep up with it.

Don't ask them to change the date. That's illegal. It would be fraud to change the dates in the system. I mean, they would risk losing the ability to accept insurance. Please don't suggest that. They won't do it, not if they have a lick of sense.

They can treat this like any unpaid bill. Up to and including suing you for it. Unfortunately, it's your bill, your responsibility. I would try, asking nicely, telling them you understand it was your job to keep up with it if they would cut you a break this one time and maybe accept half or 3/4? Don't tell them you are unhappy with them and planning to leave. Be nice, let them think you are going to keep being a patient--that will make them be more willing to work with you.

[u/ProfessionalYam3119 → u/DomesticPlantLover]

I think that you gave excellent advice.

[u/Erinbaus]

You could appeal and ask for a one time exception but it’s usually every six consecutive months from date of service. If they won’t allow it once I’d argue with the dental office or offer to pay half. They should be used to this schedule.

[u/ProfessionalYam3119 → u/Erinbaus]

One would think so, but it's not that common. If you assume that that's the default, you get lot of people who are angry because they have missed out on their second cleaning of the year. We try hard, but patients need to know their benefits.

[u/ProfessionalYam3119]

I've seen a few times when the insurance company made a one-time exception. It's rare, but can happen. You will need to ask good luck.

[u/SmartererererChild → u/ProfessionalYam3119]

I tried - hard pass.

[u/ProfessionalYam3119 → u/SmartererererChild]

I'm so sorry. All that you can do is to ask for a discount. Don't forget next time. Good luck.

[u/ReluctantReptile]

Dentists office should’ve caught this before scheduling. I’d see somebody else in the future. But there’s nothing you can do but pay

[u/SmartererererChild → u/ReluctantReptile]

That’s what I would think??? Kind of crazy I’m supposed to know the date of his last appointment. I don’t have a system in front of me with all appointment dates on it

[u/ReluctantReptile → u/SmartererererChild]

Yeah my docs office has actually called me back to reschedule because they checked with my insurance before the appt and it was too soon. Seems like your office isn’t that diligent or careful

[u/ProfessionalYam3119 → u/ReluctantReptile]

They may have enough staff to do that.

[u/ProfessionalYam3119 → u/ReluctantReptile]

You only say that because you think that they have endless days to check on every patient's plan. They don't. Especially when a new patient tells you that it's been 6 months, and it's only been 5 1/2.

[u/ReluctantReptile → u/ProfessionalYam3119]

It’s weird because my office has told me every time when there’s a mix up in scheduling like that

[u/carlorway]

Can you appeal it with your dental insurance? I feel like we had a similar situation before and the insurance ended up paying it.

If not, pay up.

[u/WVYahoo]

This happened to me. Some places just require it twice a year. Some have to be at least 6 months apart. Im sorry to hear this happened to you.

You must be in the USA like me. Whenever I have to deal with something that needs insurance the first question I ask myself is, “Do I benefit from this situation?” If the answer is yes I know something must be wrong and I need to seek clarification.

I fully expect to be screwed over whenever I deal with insurance.