Oral surgeon and health insurance

So I had a root canal done a couple of months ago.  It really sucked.  I had some issue in my mouth so I go to the dentist.  They tried to cap one tooth on the top.  That didn’t work, but I still had to pay for it.  The cap wasn’t done right so it was banging into a tooth on the bottom of my mouth.  Each time the teeth clanged together it hurt like an SOB.  So I had to go back to the dentist again who now told me that the tooth on the bottom, the one below the new cap that she just put in, needed a root canal.  She sent me off to an oral surgeon.  BTW if you ever get a root canal done when you leave the surgeon’s office you’ll be feeling fine because of the Novocaine.  When that Novocaine wears off though you’ll be writhing in pain in the dark on your bed.  So on your way home from the surgeon, get your pain script filled and take the Vicodin or Percocet right away even though you feel fine.  Don’t wait for the pain before taking the Vicodin.

Off to the oral surgeon I go.  I had an initial consultation that cost $100.  Then two additional treatment visits were needed.  The first treatment visit they drill it out and put in a temp filling.  Then you come back a week later, and if everything looks ok, they take out the temp filling put in something more permanent and off you go.

So because I have dental insurance I had to pay something like $750 and the rest would be covered by the dental insurance. That is what I was told by the surgeon’s billing office.  As far I was concerned that was the deal I accepted.

The numbers: $100 for the initial consultation, then I paid $375 after I left the first treatment visit with the deal being I’d pay the second half, $375, after the final treatment visit.  The insurance company pays the balance of like $750, so the total surgeon’s charge is around $1,500.

About a month after I was treated I got a check in the mail from the surgeon’s office for $68.  It represented a refund of some overpayment.  That was more than two months ago.

Yesterday I get a call from the billing folks in the surgeon’s office, the dental insurance decided not to pay something and they want me to pay back the $68 that shouldn’t have been remitted to me.  They’re waiting to hear back from the insurance company about the rest of the money.  The billing person told me that the insurance payment can be yanked back and I may end up owing more money.

I told her that’s not the way it works.  I never agreed to an open ended contract and that I can’t agree to something if I don’t know what it is.  The most basic rule of contract formation is mutual assent.

So the billing lady tries to explain to me that if they hear back from the insurance that some of the root canal isn’t covered that I will be billed.  I told her again that’s not the way it works.  I paid my bill in full as required by their office policy at the time that the services are rendered.   I told her it’s not right that three months later they can bill me $100, $500 or $1,000.  I never agreed to that.

Imagine bringing your car to your mechanic or having a plumber out to your house.  They give you and estimate.  You look the estimate over and based upon their assurance say, ‘fine, complete the job.’ Then three months later you get a bill from your mechanic or plumber looking for an additional $500 or $1,000.  That’s not the way it works.  The only contract I know of that can be changed at the whim of one party are credit card contracts, but that’s because they are credit card bastards.

And that is why we need healthcare reform.  Has anyone else ever been given the run around by a health insurance company?

You know who is most against healthcare reform, health insurance and pharmaceutical companies. Don’t be a tool of their vested interests.

GET OUTSIDE EVERYDAY!!! ©

I look out of a window at home to the backyard where the pool is and I see something or someone floating in it so I go to investigate.  I pull a lot of froggies out of the pool because we need to be careful with our amphibian friends.  Turns out it wasn’t a frog at all, but a….snapping turtle.  He must have made is way into the pool during the rain the night before.  Turtles can’t use pool ladders.  Eventually he would have tired out and drowned so I rescued him.

Here Mr. or Mrs. Turtle is in the recycle bin from the town.  The recycle bin is maybe two feet long so you can see that this was a good sized creature.  He was not too happy about being caught.  So I stuck a knife into his brain cavity, boiled him up and made some terrapin stew.  NO I DIDN’T.  JUST KIDDING.  Actually I dropped him off at the Terrapin Station to catch a lift home.  No, just kidding again.

I actually ran him up behind the house to a large vernal pool where he probably came from in the first place.  Here he is getting dumped on the ground, making one final hiss at me and slithering back into the water from whence he came.

You can see his open mouth hissing at me.  I think he was pretty old because his shell was covered in algae.  It felt good to save some little creature’s life.