Can I get a refund from my dentist office?!

Can I get a refund from my dentist office?

I went to my dentist for a filling. The total amount for the filling was $113. When I was checking out the receptionist told me that I would have to pay $64.30 out of pocket and my insurance will cover the rest. I wondered how she knew that, but I assume from past claims they already knew what perecentage my insurance company was going to cover. I get my explantion of benefits in the mail and it seems my insurance covered $90.40 of the $113 (the dentist office submitted the full $113 to the insurance company). The EOB is saying my responsiblity to the dentist office is $22.60. Well I figured since I already paid the $64.30, can I ask the dentist office for my refund of $41.70? If so, how do I go about that?

The reason they "knew" anything about your insurance is because they probably called and got a "breakdown of benefits". The insurance company probably gave them a percentage, but not an actual dollar amount. A dental office is always supposed to submit the full amount of the procedure to the insurance, not the estimated amount. Had they only submitted the estimated amount, your insurance company might have only paid the $48.70. Dentists ALWAYS submit their actual charge, and then the insurance determines how much they will pay.

In my office, when this happens, we always give the patient the option of either leaving the credit on their account to go towards future dental work, or getting a refund. Many leave it as a credit so they can get more work done, unless their work is completed, then we give them a refund check.

Just contact the office and explain to the person who does the insurance that you understand that your insurance paid more than anticipated and that you would like the amount you overpaid refunded to you.