September 24, 2013

Pediatric Dentists

There are no local pediatric dentists in our Insurance Network.  And of course the regular dentist will only do a cleaning on my girls.  For any other dental issues we have to go to a pediatric dentist. 

Big Ripples had an abscessed tooth a couple months back.  I think I paid around $20 at the office and was told they would bill me what was left after the insurance went through. 

I got a bill in the mail today.  $266.20


I'm going to check my policy tomorrow at work to make sure the insurance paid the right amount.    It looks like every charge exceeded what the insurance was willing to pay.  There are 4 line items all from the same appointment on the Explanation of Benefit from my insurance.  I guess I should just be happy with what they did pay.

$55, Insurance paid $39
$88, Insurance paid $0 - This was for Anesthesia
$110, Insurance paid $97
$300, Insurance paid $198

Its funny the insurance sends an Explanation of Benefits but it really doesn't explain anything.  Except for the Anesthesia, there are no explanations as to what the charges were for.


  1. My dental insurance does not pay for any anesthesia. What it does is pay a set amount for certain procedures, such as cleanings, xrays, scaling, extractions.Our cleaning are covered at 100 percent, but everything else is a 60/40 deal, with the insurance paying 40 percent. I have to come up with the 60 percent. The dentist will give me an estimate, run the numbers with the dental insurance, I get a copy, they have their copy. I pay that day for services. UGGGG. I am thankful for the 100 percent cleanings though. Everything else is a huge financial concern when the appointments start showing up on the calendar.

  2. I would really call and just double check. Can't hurt. I say this because we've found a number of issues and discrepancies with our dental provider (and I don't even have dental! But our employees do), and it's always because something got miscoded. It happens more often than anyone would like to admit. Also, if your dental insurance company has a website, check there too. Sometimes they will let you price certain procedures, and you can compare it against what they charged you.