Emry
Member
How so you might ask? So check this out...back in Feb. 2012 I had some dental work done. My insurance was through my employment. Fast forward to this week, I get a bill from the dental facility for the full amount and the claim was submitted just this past October 2013. They submitted the claim to my insurance and it stated it was denied due to late filing. So they send a bill to me in an attempt to collect. Now some people would maybe eat the $271 bill right before Christmas to get rid of the issue and have it not affect their credit history. Also, the fine print in the dental papers said ultimately I am responsible for payment. BUT, what most don't realize about fine print is the precedence of OTHER fine print. lol
1. As an "in-network provider" they were obligated under contract with my employer to file the claim within a 12 month window AND they were not to attempt restitution for payment from the insured clientele. It's called HMO and PPO contractual stipulations.
2. Their only recourse is to file for an appeal with my insurance to process the claim and provide proof and valid reason why the claim was submitted outside the allotted timeframe for payment.
Therefore, I validated my information with the insurance company and called the dental facility. The representative was all nicey-nicey and said she would contact my insurance for an appeal. I said fine, don't bother me lol. Just saved myself $271. If they should continue to harass me, I will contact the BBB and the NC Department of Insurance (believe it or not there is one lol) and file a complaint. Now, that's how a nerd handles bullies! <3
Just thought I'd share my pissy morning with ya'll and vent lol.
1. As an "in-network provider" they were obligated under contract with my employer to file the claim within a 12 month window AND they were not to attempt restitution for payment from the insured clientele. It's called HMO and PPO contractual stipulations.
2. Their only recourse is to file for an appeal with my insurance to process the claim and provide proof and valid reason why the claim was submitted outside the allotted timeframe for payment.
Therefore, I validated my information with the insurance company and called the dental facility. The representative was all nicey-nicey and said she would contact my insurance for an appeal. I said fine, don't bother me lol. Just saved myself $271. If they should continue to harass me, I will contact the BBB and the NC Department of Insurance (believe it or not there is one lol) and file a complaint. Now, that's how a nerd handles bullies! <3
Just thought I'd share my pissy morning with ya'll and vent lol.
