I'm aware of that; I used to work for the insurance company that premiered the concept. That's why I was so specific about what the policy had to say. The poster now knows what to look for in the policy. If s/he finds it, great, s/he can bring it to the attention of the dentist, or, for that matter, the provider relations department of the carrier. If s/he doesn't find it, though, s/he is stuck with the bill however much s/he feels s/he shouldn't be.



This kind of clause is, however, still the exception rather than the rule, and generally exists only with managed care plans.



mfurlan, perhaps you can show me something a little more substantial than a wikipedia article that excuses a patient from paying a doctor, or taking responsibility for seeing that it it submitted, simply because in the past other doctors or dentists have submitted claims for them. At any time during the year in question, the patient could have called the insurance carrier and found that the claim had not been submitted. At any time during that year, the poster could have submitted the invoice he received at the time of the billing (and the patient, in my experience, is ALWAYS given an invoice showing the treatment codes and any copays already made) to the insurance company directly.

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Quoting cbg
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