Balance Billing?
I am scheduled to receive a Zimmer dental implant and my oral surgeon is an in-network provider with my insurance company. The oral surgeon's office initially quoted me $1750 for the procedure. However, I was advised by a friend to ask the office to submit a pre-authorization to my insurance company, which they did.
According to the pre-authorization, the accepted fee estimate for the implant is $866.00. Delta Dental's estimated payment is $173.20, leaving my estimated out-of-pocket cost at $692.80.
When I called the oral surgeon's office to confirm the amount I would need to bring for my appointment, they informed me that I will have to pay $1576.80 (the original quote of $1750 minus Delta Dental’s payment of $173.20).
Based on my understanding, since they are an in-network provider and have agreed to the $866 fee with my insurance company, charging me $1576.80 seems like balance billing. Can someone please confirm if my understanding is correct? If so, could you advise me on the steps I should take? I have been having difficulty communicating this with my oral surgeon's office.
submitted by /u/EloquentButterfly
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