A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Any advice appreciated - anon

Posted: Apr 07, 2014

I'm having on H*** of a time with my dentist's office. They have set me up for partials; lots of impressions and bringing me in for a final fitting. I've coughed up $683, as they said this would be my portion after the insurance coverage. Apparently they sent a fax asking Aetna about my insurane coverage, even giving them the ADA code for the procedure and getting a "yes" for coverage. Now....come to find out the info they requested from Aetna was NOT a "predetermination" as my insurance encourages for procedures over $300. The hold up is a "missing teeth" clause in the insurance - more or less a preexisting issue. Had my dentist's office requested a predetermination they would have known I'm going to have to pay an additional $728 out of my pocket. The dental office said they would have asked for a predetermination had I asked them to. Really??? Why would I request they do something I didn't know about or even that it existed until now. In my opinion, the dental office dropped the ball. However, that being said they won't allow a payment arrangement either - just the full $728 to finally have my partials. Does anyone have experience with any of this and do I have any recourse at all??? Screaming at the office gal is pretty pointless and I don't see Aetna budging either. TIA

First off - see msg

[ In Reply To ..]
Screaming at people is really not a good way to get what you want. It just ticks people off and they don't want to help you. Could be you didn't help your case there.

That being said (and maybe a lesson learned), see if you can talk directly to the dentist who did the work. Calmly mention that there was a serious misunderstanding, miscommunication (word it however you want without calling anyone any names), and you're wondering if you can PLEASE work out a payment plan.

Being a crazy lady doesn't usually do much except to maybe make you feel better that you blew off some steam.

Where did she say she screamed at anybody? - Jump the gun much

[ In Reply To ..]
She said it would be pointless to scream.

Well - see msg pls

[ In Reply To ..]
When she said, "screaming at the office girl is pointless," it led me to believe she had tried that. Probably if she had "was" pointless, I would have caught on quicker.

Either way, screaming is pointless, just makes one look nuts and ready for the looney-bin.

This is what would happen where I work - Anon

[ In Reply To ..]
I'm a previous MT doing coding/insurance/billing now. The insurance companies give me incorrect eligibility & benefit information A LOT of the time, more than I would ever expect! Thus, patients sometimes end up owing a lot of money. When the mistake is made by the insurance company, we lower the payment quite a bit, calling it a "prompt pay discount." Most of the time, our patients have a fit and just flat refuse to pay, and that's where it ends because the office I work at doesn't use a collection agency.

So, I would do as suggested above -- first talk to the office manager or doctor. Bottom line, it was NOT YOUR FAULT. If they will not discount the price and/or work out a payment plan, I'd just tell them you'll pay them what you can when you can. Chances are they do not use a collection agency as it can cost more than what they will collect, and you will know soon enough if this is the case. Then I'd pay them $5 a month until they write it off (18 months in my office).

Good luck! Hope you can work something out.

Sounds like you should be upset with Aetna, not them - sm

[ In Reply To ..]
When they gave that code, they were verifying coverage for the dental work. In a case like that, the dental office did their part (if I am understanding this correctly).

At our office whenever we schedule procedures, we provide our patients with insurance verification forms explaining the insurance & billing process so they know to call and check with their insurance and get an idea of out of pocket costs etc. We also call insurance to get pre-detetminations/ prior authorizations and verify benefits in addition to providing patients with insurance verification forms.

well there's the rub - anon

[ In Reply To ..]
The doctor's office didn't send in a predetermination, just a request for benefits covered. They told me I had to ask them to send Aetna a predetermination request, that the doc's office doesn't normally do this. Great, they got it verified that I'm covered for partials, but after a closer look they will only cover them if the missing teeth were not missing prior to beginning this process of the bridge. Yes, I'm angry with Aetna, but I'm not thrilled with the doc's office either. Something as expensive as a bridge ($1300) should have gotten a predetermination. Now I'm left blindsided and still no bridge. Yes, I spoke to the dentist personally. All she did was complain how much she had to write off of the actual cost due to what Aetna was willing to let her charge (the customary and reasonable thing). I am going to pay half in 2 months and 1/2 in another 2 months. The complaining she did about how much Aetna makes her reduce her fees was kind of shocking to me. One if she doesn't want to deal with Aetna stop choosing to be a provider, and two heaven only knows how much she actually tries to charge before Aetna says enough. I liked this dentist but all-in-all her attitude was basically "do you know how much your insurance has cost me in fees". I don't think I'll continue seeing her after this. Shame too, my kid goes to her as well.

Similar Messages:

Jan 30, 2011

I wonder if any companies anymore both big and little appreciate their MTs for what they do, if they are high producers, good quality and in the case of an IC work a good dependable schedule for them. I get the feeling that they just think oh well they can all be replaced with all these MTs out and about looking for jobs. I never saw so many hits on jobs as I have seen lately. I dont know how anyone ever gets a job unless there are a lot of underqualified people out there looki ...

Jan 08, 2014

Are there any companies left out there that actually pay decent and are nice to work for and appreciate quality work? ...

Nov 28, 2013

I ercently started with a company and posted prevously about how the recruiter had sent me a greeting card welcoming me to the company. In addition, I also received a greeting card from the person who trained me when I started with the company. I got up this morning (Thanksgiving) and had receieved a Thanksgiving greeting card from the company, stating how thankful they were to have me as a part of their team. In today's market, I thought that was a nice personal touch. ...

Feb 11, 2015

I have had only good experiences with TT account managers. They have always answered my emails promptly and been very willing to be flexible with my scheduliing. AD has always taken the time to make personal phone calls to MTs when more info is needed or something didn't go through the system, to make sure they get paid on time. I'm sure they share our stress over the accounts going to EPIC. I just wanted them to know they are appreciated for all their hard wo ...

May 12, 2015

My QA scores have been primarily 100%, the lowest something like 99.6 and very infrequently anything less than 100%. My QC scores are consistently 0% as I never send anything to QC. I work my schedule without exception. Even when there is no work, I remain logged in and ready to work. My work is excellent as I have been transcribing for a very long time. I sent my TSM an email that I was resigning. The reply was "I'm sorry to hear that you are planning on resigning." I was not planning on ...

Dec 13, 2009

xx ...

Oct 06, 2010

Their ads do not require previous experience as an MT, and you have to purchase a different foot pedal. Is this unusual? Thanks in advance for any advice. ...

Nov 02, 2010

Can anyone tell me what the employee cost for a single plan with SoftScript is? Also what is the added CPL for 2nd shift differential? ...

Feb 08, 2011

I would like to say this is not an attempt to bash Keystrokes, but an attempt to learn more from those more experienced with MModal. Keystrokes is gradually transitioning to MModal. I am trying to be positive but it is becoming more and more difficult. One of my main dictators has a less than 20% rate of SR being correct. I find it faster just to delete the whole job and do over. Th ...

Aug 14, 2011

I was not able to find recent information about them. 1. Are they honest? (I recently had a bad experience) 2. Is there steady work? (I did not have that.) 3. Are they flexible? 4. Benefit information. I would apreciated any infomration. ...

Nov 03, 2014

Let me start by saying that I live in a rural area and because I am about a quarter mile from my mailbox, I do not get my mail daily. My landlord came over today (Monday), with my mail and one of the items was a belated birthday card from the company that I work for United Transcription. It is nice to know that there are some smaller, apparently caring companies out there. ...

Dec 16, 2009

Any information is appreciated on format, pay, etc. ...

Jan 04, 2010

I am starting up my own MT business and have been in the process for about six months now. I just do not want to get it up and running and realize that I forgot something or messed up somewhere down the line. My main concern is the new HITECH Act that goes into effect in February. I plan on having a couple of girls working for me from their homes and I am just confused on the exact rules and regulations that coincide wtih this new act. Also, I need advice on the best way ...

Mar 02, 2010

.. ...

Mar 27, 2010

. ...

Jul 15, 2010

I have an interview tomorrow and I am so excited I can barely contain myself! The only problem is that it is in medical reception and I have never done it. I have done basic reception for a plumbing company and have done transcription for 5 years. The only reason I need this job is because I deperately some extra income coming in and this job is only 2 days a week, which makes it perfect since I am a single mom of 3! My ex told me he would rather go to jail then pay ...

Jul 29, 2010

NM ...

Feb 18, 2011

x ...

Aug 05, 2011

Especially interested in their pay scale. Thx ...

Sep 25, 2011

.. ...

Oct 14, 2011

nm ...

Sep 15, 2012

Trying to decide whether to join up and have a few questions. Thanks in advance for taking the time to answer. And, the reason I am asking here, is that I trust your answers over the suits. How long from offer to actually starting work? (Since I know they do a background check and have a lot of paperwork.) How long from starting work to actualkly getting a paycheck? How long is training on platform (DQS)? How long to be fairly productive after training? What is ...

Mar 06, 2010

I passed all testing and now am up for an interview with Chronicle and was hoping for some more input on company. I see some posts, but older ones and would like anyone who might currently be working for them regarding lines, pay, work available, etc. I am currently with a company, SoftScript, and really need to get out, but do not want to go to another company just as bad. Thanks. ...

Jan 21, 2011

x ...

Jan 31, 2011

s ...

Jul 29, 2014

I was just at the AHDI Conference and talked to Amphion..I know they only pay for black characters on a page, no spaces or headers or footers...looking for comments from Current Amphion employees...how do you like the company and can you make any $$ there? ...

Dec 04, 2010

Does anyone work for or has anyone heard of Sandia Medical Transcription out of Albuquerque, NM? They call themselves the “Internet Dictation Service for Traditional Catholic Doctors” and their website states they “serve doctors, regardless of religion, who only perform moral medical procedures.” It sounds like they only do straight transcription (no SR) and only hire Independent Contractors. Anyone have any insight into this company? Any information would b ...

May 19, 2014

TIA ...

Jun 21, 2012

I'm a former MT who decided I couldn't live "peaceably" with VR (LOL) and left MT a few months ago. I've had some trouble finding a job outside of MT since then, though. I'm willing to branch out, but I suspect that after many, many years of doing MT, some employers aren't willing to take a chance that I'd be happy long-term in a less-challenging job. (The applications I most often get a response from are medical-type jobs.) Maybe they'r ...

Feb 18, 2014

Xx ...