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Originally Posted by Bill14564
Was the work done? Would you have had the work done if the cost breakout was different? When the insurance company disputed the charges and provided an explanation was the explanation something the dental office could have reasonably known about ahead of time?
Personal experience with this office: I needed a crown replaced and was provided an estimate of the cost breakdown. I needed the work done so I had the work done. The insurance company refused some of the charges because the original crown was put in just under five years ago (four years and ten months but still under five years). There was no way the dental office could know that the original crown had been there less than five years. I had to pay more than expected but in this situation I can't blame the dental office for that.
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Actually you CAN blame them because when they submit to insurance which they should (and can) do while or before you sit there they would have known and told you (not that you wouldn't have had it done but your dentist COULD know before doing the work). They simply didn't get a pre-authorization. Had they done that you would have known.