Born to be Screwed – a hypothetical insurance tale based on actual events

I go to the dentist for a cleaning. It’s covered by insurance. I inquire about a veneer that a previous dentist said would cost $1,000 and that my insurance wouldn’t cover. This dentist not only says the insurance *would* cover it, but that I didn’t need a veneer at all, rather a filing. They can definitely work the insurance into this. And, “let’s check with your insurance company, ah yes, here it is – your total out-of-pocket will be only $80.” 

I schedule the procedure for the next day. I pay the $80. I’m happy. 

Two weeks later, correspondence arrives from the dentist’s office. It’s a bill for $76. There are 10 lines of charges and credits from different dates that make no sense. Even two successive lines that make no sense at all – one for a charge of $5.20 followed by a credit for the same amount – with no explanation. I know that this is all a plan to confuse. 

I call the dentist. It’s an automated service with only two prompts, one to confirm an appointment and one to make one. I push ‘0’ – ‘Sorry, that’s in invalid option’ – and a kick back to the main message. Because I don’t know my party’s four digit extension, I try random numbers. Nothing works. I hang up and call back. I choose ‘make an appointment’ option figuring I’ll get a person who can connect me to billing. No luck – leave a message. [Please note – this is a BIG practice. Thousands of patients. Just no way to reach anyone via phone – unless you know the extension. There’s no extension number on the invoice.] 

I’ve been through this a hundred times in my life so I know what will happen next – I’ll call the dentist and they’ll say something about this being my responsibility and that I should know what my insurance covers. Even when I’m sitting in a chair with a suction tube in my mouth. And they’re right. I should. But, I’ve never read through the mouseprint in the insurance manifesto. I just want to know it’s there and that it covers stuff. So I’ll call the insurance company and they’ll say that their coverage is very clear had I read it. After all, I should know what a ‘1 surface anterior composite is’ is in context to my coverage. 

The dentist will say they’ll resubmit the paperwork and the insurance company will say they will look into it more. And in a couple weeks, I’ll get another bill from the dentist’s office for the same amount. Maybe there will be a handwritten note explaining that they’ve done everything they can. I’ll never hear back from the insurance company. And I’ll have no other option but to pay the bill or risk my credit rating. 

I won’t pay. My credit report will show it. And I’ll get on the phone with the credit company…