Why would my dentist office submit the same claim multiple times to my dental insurance company? Â

Why would my dentist office submit the same claim multiple times to my dental insurance company?  

answers 0:What happened was, my dentist said I had to have a $2,000 treatment plan. My maximum insurance benefit (from the company) is supposed to be $1,600. So I paid about $430 in cash up front to cover my end of the cost, and they said everything was fine, I took care of it. Now the dentist is sending me a bill for $300. Researching online, it looks like (under claim status) that my dentist submitted the same work claims (like two claims for the SAME teeth) more than once, and they have tried to collect $4900 from the insurance, and it also looks like my insurance has paid out over $2000 when I was only supposed to get $1600 in benefits? Any ideas please? Customer service is closed and I hate not knowing answers like this over the w! eekend... I need peace of mind of knowing what the problem could be. Should I pay this $300 bill when the dentist said that I only pay $430 and I did?...Show moreanswers 1:First of all, your insurance company will not pay out more than you have in benefits. They just don't.Next, "it looks like" does not mean that's what happened. Insurance company processing would catch multiple claims on the same procedure codes, same teeth. It is possible there were different codes billed out on one tooth (crown buildup for example), but your insurance certainly won't pay more than they allow.When you are given an estimated co-pay, there is no way for your dental office to know exactly what limitations and allowances your insurance company has. Their estimate may be off by a few hundred dollars, due to clauses in your plan unknown to the dental office. Forget about this for the weekend. On Monday, call the insurance company and ask about what payment they made. Chances are you have mis! understood what you saw online.If your insurance company paid ! less than estimated, you will be responsible for the balance of your bill....answers 2:You should (try to) forget about it until Monday. Then you must contact your insurer and tell them you suspect fraud. I worked in billing for many years and some healthcare providers are dishonest; others just have incompetent office staff. If no fraud is involved, you may actually owe the extra $300. Sometimes medical insurers don't cover some costs (I swear I think they flip a coin to see what they'll pay!); for example, I paid an extra $300 once because I required extra anesthesia during a wisdom tooth extraction. One physician billed me, and my insurer, for 2 office visits that occured on a Saturday (their office is closed Saturdays). So relax! Let your insurer investigate. That's what they're for!...answers 3:This is the way it is in Canada. Ask your dentist for a copy of your payments. That copy will show how much you paid, how much your dentist billed the insurance for a! nd what type of work that was done. It will tell which teeth the billing is for too. If it doesn't you should contact your insurance company and let them look into it.