Cancellation Fee for appt

[disneysteve]

Originally Posted by Like2Plan

Dr can set a policy, but doesn't it have to meet some reasonable standard? For example, what if the dentist policy was a cancelation fee of 1,000 or 10,000 or 100,000 (because he's got college loans to pay off).

Oh, I agree totally. I think the $350 fee is insane. A cancellation fee should be a modest amount just to serve as a deterrent, no more than $25 I would think.

[LivingAlmostLarge]

How's this? He also did not refund me my money when I overpaid the last time I was there. If I had not gone back and had a bill, which I did not for the cleaning, then he would have KEPT my money. MY MONEY was being floated to the DENTIST.

The insurance company is having me fill out paperwork so they can investigate his insurance claims. Apparently this is very serious.

[DebbieL]

Good for you LivingAlmostLarge. I hope they find all sorts of fraudulent insurance practices going on, lol. Sorry, but I'm very mad at them on your behalf. I hope you are in the process of finding a new dentist?

PS - My husband's dental insurance is running out at the end of July (he just found out this week). His dentist squeezed him in for a cleaning, X-Ray and 3 fillings (total cost of less than the $350 cancellation fee you got). Our share of the payment came to $64. They also credited him with about $5 that he overpaid the last time. He needs two extractions done, and they even rushed him in and the surgeon agreed to do it next Monday so he would be covered. The total cost for the surgery will be $630 (that includes a general anesthetic). Our portion will be about $125. I am grateful that my DH has such a good dentist and that their practice deals with all the insurance issues for him. I hope you find one similar! Good luck.

[My English Castle]

Oooh--that makes me so mad. Good job sending the insurance company after him.
When I first moved to this area, I had a dentist who I found out consistently double-billed everything, using a very confusing billing system where procedures were never named, only identified by some arcane runic numbers.

I thought the bills were too high, and pushed and pushed his office to figure out why. Eventually they gave me some blather about an "adjustment" although I know they were double-billing. Turns out he did the same thing to some co-workers and eventually we got him delisted from our insurance provider.

It probably is a good idea to get this known in your area. If he did it to you, I suspect you're not the only one.

[LivingAlmostLarge]

Nope he figures he charges the insurance and the client. Then he keeps both money and say he's holding it for the client. At least that's what the receptionist said when I was questioning her about my credit. I nearly yelled at her, but I didn't, and I said I will be talking with the insurance company. She was not happy about that.

But he's floating other people's money and not returning it. What's the deal with that?

[m3racer]

Originally Posted by LivingAlmostLarge

Nope he figures he charges the insurance and the client. Then he keeps both money and say he's holding it for the client. At least that's what the receptionist said when I was questioning her about my credit. I nearly yelled at her, but I didn't, and I said I will be talking with the insurance company. She was not happy about that.

But he's floating other people's money and not returning it. What's the deal with that?

what you're saying doesn't exactly make sense. So he charges you the usual customary fee and than he bills your insurance company the exact same fee? I hope you have solid evidence because those are serious accusations you are making. Simply put it's called insurance fraud....I doubt your dentist is that stupid ....of course I could be wrong.

[disneysteve]

Originally Posted by LivingAlmostLarge

Nope he figures he charges the insurance and the client. Then he keeps both money and say he's holding it for the client.

We often, for one reason or another, end up with an overpayment on a patient's account. Generally, we do hold it as a credit on the patient's account and apply it next time they come in so, for example, they don't have to pay their copay. There's nothing fraudulent about it as we aren't keeping the money. It gets back to the patient at some point.

[DayByDay]

Originally Posted by disneysteve

We often, for one reason or another, end up with an overpayment on a patient's account. Generally, we do hold it as a credit on the patient's account and apply it next time they come in so, for example, they don't have to pay their copay. There's nothing fraudulent about it as we aren't keeping the money. It gets back to the patient at some point.

I guess this is what my OB doctor did. He required a bunch of cash up front ($1,344) at my first pre-natal appointment because I don't have great insurance coverage. After the baby was born he billed the insurance, the insurance paid their share, and it ended up that the doctor owed me $750 back. In addition to not being happy that he held onto my money so long, interest free, for some services not yet rendered, I also wasn't happy that the overpayment wasn't automatically refunded to me. I finally had to request the refund. That's a lot of my money they were planning on holding on to.

What happens if the patient never returns? Do doctors just pocket the money? I imagine there are some patients who don't understand or even read their insurance statements and might not even realize they are due a refund.

[disneysteve]

Originally Posted by DayByDay

it ended up that the doctor owed me $750 back.

What happens if the patient never returns?

I'd have to check with our biller as I'm not involved in that aspect of things. Being in family practice, we don't have charges that large typically so when we have an overpayment, it is generally much smaller, like $20 or $30.

As for a patient who never returns, I'll try and remember to ask her next week if she periodically goes through the accounts that have credits and issues refunds. I'm guessing she doesn't as, in our practice, half the time we don't have accurate phone numbers or addresses on many of our patients and tracking them down can be difficult or impossible.

[PrincessPerky]

Originally Posted by DayByDay

I guess this is what my OB doctor did. He required a bunch of cash up front ($1,344) at my first pre-natal appointment because I don't have great insurance coverage. After the baby was born he billed the insurance, the insurance paid their share, and it ended up that the doctor owed me $750 back. In addition to not being happy that he held onto my money so long, interest free, for some services not yet rendered, I also wasn't happy that the overpayment wasn't automatically refunded to me. I finally had to request the refund. That's a lot of my money they were planning on holding on to.

What happens if the patient never returns? Do doctors just pocket the money? I imagine there are some patients who don't understand or even read their insurance statements and might not even realize they are due a refund.

I switched OBS for that reason, the first wanted almost 2K up front when I was pregnant with my DD, having lost two kids the last thing I wanted to risk was needing to call a doc after a loss to pester them for my money back...

Now my Ped charged a percent of total bill (insurance was set up that way) which came to one number, but the insurance also got a discount..making my percent owed less...so I ran a balance all the time with that company..royal PIA to keep track of but I understood the reason.

[LivingAlmostLarge]

Um, so if they never return what does happen with the money? That's what happened is I overpaid and the insurance overpaid, with I guess the assumption that I'd be back. No plans of ever going back again.

[neatdesign]

Maybe it goes to the state's unclaimed funds department?

I got a check for about $100 about 2 years ago when I searched under my names (maiden, divorced and current) at my state's online unclaimed funds database -- an overpayment for a telephone bill from 5-6 years previously. I'm not sure what the laws are but merchants can't just hang on to those funds indefinitely, so that's why they end up with the state eventually.

~ Jenney

[Fern]

I would never have said "fine" to a cancellation fee especially since you cancelled the day before. Usually it's ok if you give them 24 hours notice. $350 IS excessive. I'd ignore it.

[Fern]

I am still trying to get a $40 overpayment refund for some co-pays i paid my optometrist. I have spoken to his people at least 3 times, and this goes back to an April visit.

This burns me up. They insist on payment in full on the day of your visit, but try to get money back that is rightfully yours. It's just one vague answer after another. I'm ready to switch doctors over it.

[StressLess]

I agree with contacting the state board of dentistry. I found on their website that Massachusetts dentists can get in trouble for "charging for services not rendered." Here is a link to the .pdf file:

http://www.mass.gov/Eeohhs2/docs/dph/regs/234cmr002.pdf

Here is contact info, might be worth calling to ask questions:

Board of Registration in Dentistry
Phone: 1-800-414-0168 or 617-973-0971
Fax: 617-973-0982
Also, see this page on the American Dental Association website, under "What happens if I miss a dental appointment?"

"Dental offices vary on their policies of missed appointments. Ask your dentist about his or her policy. Many dentists ask that you call to cancel an appointment at least 24 hours in advance. This will allow time for office staff to find someone else for your scheduled appointment. Those who don't call to cancel may be charged all or a portion of an office visit."

Since you did call to cancel, I don't think they have a leg to stand on--especially since it had to do with their lack of knowledge about the insurance situation.

I had one doctor try to pull this on me, and when I explained why, they dropped it. Recently, we had an appointment for my husband and the problem resolved itself before the appointment came. When I called to cancel, I asked if there would be a fee, and I was told no, very emphatically. The woman in that office said that no medical office should charge for cancellations, that it would be fraudulent.

Good luck, and don't give up!

[Coleroo]

what a horrible thing! $350.00 for an unkown, unagreed upon cancellation fee (cancelled a day ahead) is far too unreasonable. I would be outraged myself.

..other topic...

I had a terrible terrible experience at a doctors this past january, and ended up running out and bursting into tears over the incident (rude, rude rude secretary). I have GREAT health insurance at my current job.... upon leaving I had paid upfront 99$ for something i knew was covered in my insurance (not the reason i burst into tears though). i just thought, hey, once my ins comes through I'll get a refund. 2 months later, i received notice that my insur had paid in full - and the 99$ check was sent TO the doctor. I called my insurance, informed them I had no plans to ever return to that doctor EVER. they said give it a few weeks and the doctor should issue a refund. May rolls around - i had received nothing. I called my insurance again and they called the office for me.

Apparantly, unknown to me, they keep all return money as a credit on the patients account. Well, i let her know I had no plans of returning, please send a check. That was May 13 - they didnt cut a check back to me until June 25.

Moral of the story is - be aware that your medical office may issue refund checks when they come in and they may not even notify you that you have money on the account. if I wasn't on top of things (details of my insurance plan), I may have not even realized i should be receiving that money back. some people may have just paid out of pocket and left forever and not realized!

I wonder how much money some unscrupulous doctor offices manage to keep? bleh.

[anonymous_saver]

I would also send a letter demanding your $20+ that you had overpaid previously. Also, in this letter state that you will go to the State board of Dentistry and BBB. Seriously, you should do this!

Good luck!

[LivingAlmostLarge]

Followup after my letter to them the dental office responded. They said they had no documentation about my change in coverage. THIS is obvious because I am a student without insurance who is covered by my husband. My husband changed jobs and thus his insurance provider changed from Blue Cross to Delta Dental. I will be sending back proof of change of insurance, though I told them over the phone and in person at the office.

Second they said that they DO NOT get preapproval of work done from the company. Which I called Delta Dental up and they said pre-approval had to be done FIRST. Thus they were lying because they are NOT delta approved dentist. They claimed the Delta Representative miscommunicated to me about their policies that a pre-approval of claim was not necessary.

Thus I had a broken an appointment and they were charging us for broken appointment $350. And the carryover fee was to be applied to future visits so they did not have to return the money to me from 2 years ago.

In the letter they did not say I had to pay the $350, though they did state they had a right to charge for a failed appointment. Does this mean I owe them the $350? I plan on arguing with them more anyway again but what should I expect?

I plan on sending in my change of insurance. I also plan calling delta and sending them this letter showing that I was told I didn't need "pre-approval" that delta required. Also I'll be reporting them more to the BBB after I settle this more.

[Scanner]

To echo DisneySteve's policy, we don't return overpayments right away either - just generally give a credit on the patient's balance.

To complicate matters, I outsourced my billing 2 years ago to a billing company.

Even if I wanted to somehow have credits returned, it would be a difficult proposition. I'd have to have the billing co. notify me and then I'd cut a check. Not impossible though.

I'll look into it with my billing service since this seems to be a sore point with the forum. At a chiropractic office, you are only talking usually $10 to $50 at the most.

Unfortunately, and I don't think anyone who doesn't work healthcare will agree with me, I think all payments should be made in full to the doctor and then YOU submit it to your insurance company.

Health insurance/dental insurance is a contract between you, the employer, and the insurance company.

I don't know how doctors ended up in the middle of all this craziness.

Then all of this Tom Foolery with credits and balances wouldn't come into play. The balance would be zero each time - just pay be credit card, check, or cash.

But the idea of actually paying the doctor in America has become a foreign concept and the accepted tender seems to be an insurance card.

[LivingAlmostLarge]

Heck I have no issues with paying, I have issues with being ripped off. I don't like the fact we have to get preapproval by insurance for everything or else we run the risk of paying completely out of pocket 100% of the costs when the insurance suddenly claims to not cover the expense. Or am I wrong?

No way. Plus you have to be in versus out of network the coverage is different. And you have to be very careful or you could be caught like me where the dental office lies to you and says they take delta dental but are an out-of-network provider, so the coverage isn't as high as a in-network provider.

Please the US system is a mess. There is so much inefficiency/stupidity it's not funny.

But what is the point of having insurance if you constantly have to be sure to be within the boundaries of coverage? Scanner your way would mostly work if we just didn't have insurance and paid out of pocket. If we had to submit all expenses, the insurance companies would royally screw us and say we're not covered. Wanna bet on that? They do it now even with direct billing, how much worse would it be when the consumer would have to do it themselves?