Asked by dentist to pay upfront, get refunded by insurance later. Legit?

Post date: 2021-04-14 19:47:32

Much to my surprise, I was told right after dental surgery that I needed to pay the whole amount right then and there (because a "specialist" was involved), and that I would later be reimbursed by my insurance company for their share of the bill. Considering that they didn't bother to mention this before the surgery, I was just wondering if this is standard operating procedure or not.

The dentist I've been seeing for over a decade retired a few years back and sold the practice to another dentist. (Can't say I prefer him over my old dentist, but I haven't had any real problems with him either). I made an appointment with his office for gum surgery and was told that, while the surgery would cost $XXXX, my share would only be $XXX post-insurance. What his office neglected to mention at the time is that I would have to pay the whole amount upfront since a "specialist" was handling the surgery, and that the insurance would cut me a check back for the $XXXX they took care of. (The office rep apologized for "forgetting" to inform me about this when I made the appointment). To say that this would be a surprise would be an understatement; however, I was still fairly numbed out at the time and agreed to a payment plan in the meantime.

This is the first time in decades that I've needed any dental/gum surgery done, so I'm admittedly unfamiliar with dental billing methods for said procedures. Is it standard (or at least not unfamiliar) practice to pay up front for dental/gum surgery and then be reimbursed by your insurance later? (The fact that his office just suddenly sprung it on me makes me wonder, though they haven't been the most organized bunch before now anyway). Worth noting that the "new" dentist is still (supposed to be) in-network.

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