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  1. #1

    Default Wrong Quote and Now Collection Agency on My Neck

    My question involves collection proceedings in the State of: illinois
    In 2008 my primary dentist sent me for some special gum treatment to periodontist specialist.
    I went for a quote and after my acceptance i scheduled the treatment plan which was set for two visits.
    When I received the initial quote it was mentioned my payment and insurance payment was left blank resulting of total amount to be same as my amount which i should pay at the time of the treatment.
    By my insurance rulls I can go to any dental specialist which has chosen to participate in the same network of providers.I verifyed with my insurance that this specialist is part of the network and I was told that each specialist dental office regulates their own prices and they are agree to give 25% discount of their regular prices.This was my understanding why insurance portions was left blank.Since I knew that they have to offer 25% discount(nobody never give me their regular price)I was thinking that the amount which I have been quoted is the amount with 25%discount included.
    I received first treatment and paid quoted amount for this visit in full.So far-so good.Two weeks later I received second portion treatment and paid in full too.
    About two weeks later I received a letter from this office stating that insurance company has refused to pay the difference between the amount which already is been paid by me in full(for which i have been quoted)and their actual price which resulting in about 40% discount from their regular price.I was informed that I owe them about $650.00 ...The interesting thing is that this happening after everything is completed and at that moment i couldn't do anything.I tryed to resolve the issue with this office telling that I have a quote and I paid the whole amount which I was quoted and if they did mistake-is not in my part,so they should accumulate the loss ,because is their own mistake.They refused to discuss this my attempt to resolve it and I started to receive letters that my account will go to collection agency.
    Sure enough two days ago i received a voice mail from this agency with call back number and today my boss told me that same guy from same agency was looking for me at my work place.
    My questions to you is:
    -Is there is any way that I am liable for this amount-i am treating this quote like writen agreement between us.I paid all amount in full.
    -What is the appropriate steps to do now?-do I need to call this agency or i should stay and wait to see what is going to happen?
    -I never been in touch or trouble financially-I kept all my credit card bills paid in full-house paid off-dont'know what to expect...
    -how bad things can go...
    -Please advise me....

    Thank You for your time and help.

  2. #2
    Join Date
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    Default Re: Wrong Quote and Now Collection Agency on My Neck

    I have no idea what you mean by the "quote" being wrong. Are you stating that they told you the price, and what you were expected to pay after insurance? The price is the price. The fact that you had less insurance coverage than they thought would be something you could have recognized up front, and the contract you signed with them would normally state very clearly that you're responsible for any balance due if the insurance pays less than was anticipated.

  3. #3

    Default Re: Wrong Quote and Now Collection Agency on My Neck

    Thank You Mr.Knowitall for your reply!

    What I mean is that they gave me amount,which have to be only my responsibility-without any insurance co-payment-because, in order for them to practice in this network-they have agreed to joint this network giving all patients 25% discount.In this case Insurance company doesn't have any obligations to pay at all!This is the deal just between me and the specialist!
    So what they did-they gave me amount-which i have paid in full and now they ask for more money-they were expecting that Insurance will cover the difference...even I haven't signeed or agreed for asking amount.Seems that they did't know what is the agreement between their office and my insurance!And because they were turned down-that's why they pass this bill to me...By the way-I never signed and agreed to pay the amount which they try to cought me.
    I know it's a mess-so if is still not clear-let me know!


    Thank You again!

  4. #4
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    Sep 2005
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    Default Re: Wrong Quote and Now Collection Agency on My Neck

    That does nothing to clarify the situation. If you have difficulty communicating your thoughts in writing, consider getting a friend or relative to help you post.

  5. #5
    Join Date
    Oct 2006
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    Default Re: Wrong Quote and Now Collection Agency on My Neck

    Confusing to read, but here's the way I see it...

    "In network" can be different than "contracted". Is this an actual insurance policy, or one of those discounted plans being advertised having thousands of providers in the"network"?

    From what you've stated, the provider's only "agreement" is to discount their REGULAR fees by 25%. They are under no obligation to the additional 40% discount.

    You are responsible for the difference.

  6. #6

    Default Re: Wrong Quote and Now Collection Agency on My Neck

    Thank You lealea1005,Mr.Knowitall,

    This is directly from my provider's web site:


    " Our plan is not an insurance plan. It is a Prepaid Dental Plan which makes benefits available from selected Participating General Dentists and Participating Specialists.
    You enjoy benefits without deductibles, pre-existing conditions, or maximum benefit limitations. You, as the patient, pay your dentist the copayment amount stated in your Schedule of Benefits. The financial arrangements for
    making these copayments are strictly between the dentist and the patient. There are no claim forms to be filed."

  7. #7
    Join Date
    Oct 2006
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    supratentorial region
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    818

    Default Re: Wrong Quote and Now Collection Agency on My Neck

    Quote Quoting Just one bill
    View Post
    Thank You lealea1005,Mr.Knowitall,

    This is directly from my provider's web site:


    " Our plan is not an insurance plan. It is a Prepaid Dental Plan which makes benefits available from selected Participating General Dentists and Participating Specialists.
    You enjoy benefits without deductibles, pre-existing conditions, or maximum benefit limitations. You, as the patient, pay your dentist the copayment amount stated in your Schedule of Benefits. The financial arrangements for
    making these copayments are strictly between the dentist and the patient. There are no claim forms to be filed."

    Ahhhh...that's what I thought. It's NOT an insurance policy, it's a discount plan. The problem is you have no idea how the "arrangements" are presented to the dentist/specialist. I hate to be the one to tell you this, but that "agreement" is not a "contract". They are not required to accept anything other than their usual fee. You are lucky to have been given a discount at all.

    What is the amount stated in your scedule of benefits for the actual services provided?

  8. #8

    Default Re: Wrong Quote and Now Collection Agency on My Neck

    Thank You lealea1005,

    The problem is that this procedure is not on my Schedule of Benefits. And this is from my agreement:

    "UNLISTED PROCEDURES ARE AT THE DENTIST’S USUAL FEE LESS 25%."

    So when I received the initial quote-it wasn't specify how much is usual fee,how much is my co-payment or how much is my discount.It was saying like that:


    procedure patient insurance total
    --------------------------------------------------------------------------

    XYZ $1500.00 $1500.00
    --------------------------------------------------------------------------

    patient signature......



    That's all.
    So in my case I paid all those $1500.00 in full and in top of that amount they are asking another $650.00 ...for which my dental provider refused to pay.

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