Does this make sense -- Dental Insurance Claim

Post date: 2020-09-18 13:35:39

I'm confused about my most recent dental insurance claim, did my dentist's office mess up? Or does it actually make sense? (Canada, if it makes a difference)

This might be a bit of a brain fart question, but I'm confused!!

I had a dentist appointment about two weeks ago. When it came time to pay, the receptionist informed me that their internet was down, so they couldn't submit my claim to my insurance company or process payment. I had to book a follow up appointment anyway and the receptionist told me that they'll bill my insurance company and just have me pay whatever my dental insurance didn't cover during my next appointment.

The dentist office submitted my claim the next business day and the amount claimed was ~$400 (let's say), my insurance paid ~$320 of that amount and I'll pay $80 to the dentist's office. All good.

Now, this is where I get confused. Shortly after the claim was submitted, my insurance company reimbursed me and deposited the $320 in my chequing account, but I never "PAID" that amount!?

I haven't paid for anything yet! I'm assuming that the insurance company is assuming that I paid for the full amount at the time of the visit? Right? But because I never paid that full amount, this is confusing me. Had their internet worked, I would have paid the full $400 at the time, then been reimbursed the $320 at a later date, but still paying the dentist's office $80. It just feels like they SHOULDN'T have deposited the $320 in my account, because I never paid the full $400 up front, but was it actually a mistake? Do I need to report this to the insurance company?

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