a*****a
发帖数: 19262 | 1 一直以来我都是用的一个牙医，老公也是，我们怕麻烦，懒得换，服务OK。但是BILL很
烦，小数目，都不会管了，最近我发现，一张BILL，CHARGE的时候算保险只COVER40%，
结果保险公司来的单字是COVER60%，也就是说我多付了20%（+100刀）。事先说的，如
果他们OVERCHARGE，他们会退回来，我以为，这些都是自动的，不需要我们去CHECK。
看他们的BILL实在太难懂了。过了一个月也没有反应，我差不多明白，如果我不去问，
牙医那边就很自然的多收那些钱了。
我是不是应该换牙医？还是所有的牙医BILL都是这么混乱的？这么多次账单，我都无法
把保险公司的账单和他们的账单相吻合。 |
m**x
发帖数: 8454 | 2 normally each customer will have his/her own account, the remaining balance
will be there. Unless you want to change dentist, you don't need to care
about the over-payment. Of course if you don't feel comfortable, you can ask
them to send a check.
Check bill is not difficult, you based on explanation of benefits sent by
insurance company. It says how much you should pay. If you paid more than
that, you get the difference back. You do not need to calculate based on 60%
or 40%.
【在 a*****a 的大作中提到】
: 一直以来我都是用的一个牙医，老公也是，我们怕麻烦，懒得换，服务OK。但是BILL很
: 烦，小数目，都不会管了，最近我发现，一张BILL，CHARGE的时候算保险只COVER40%，
: 结果保险公司来的单字是COVER60%，也就是说我多付了20%（+100刀）。事先说的，如
: 果他们OVERCHARGE，他们会退回来，我以为，这些都是自动的，不需要我们去CHECK。
: 看他们的BILL实在太难懂了。过了一个月也没有反应，我差不多明白，如果我不去问，
: 牙医那边就很自然的多收那些钱了。
: 我是不是应该换牙医？还是所有的牙医BILL都是这么混乱的？这么多次账单，我都无法
: 把保险公司的账单和他们的账单相吻合。
|
a*****a
发帖数: 19262 | 3 动不动有些项目保险不COVER，有些是DOWNGRADE，牙医那里是这么说的，所以PAY多少
比例我都看不出来了。虽然保险说的很清楚（90%，60%等）
balance
ask
60%
【在 m**x 的大作中提到】
: normally each customer will have his/her own account, the remaining balance
: will be there. Unless you want to change dentist, you don't need to care
: about the over-payment. Of course if you don't feel comfortable, you can ask
: them to send a check.
: Check bill is not difficult, you based on explanation of benefits sent by
: insurance company. It says how much you should pay. If you paid more than
: that, you get the difference back. You do not need to calculate based on 60%
: or 40%.
|
m**x
发帖数: 8454 | 4 You don't have EOB sent by your insurance company? You don't need to
calculate, it should tell you how much is your responsibility. First bill may be just a estimation. Once they receive the payment from your insurance they will adjust.
【在 a*****a 的大作中提到】
: 动不动有些项目保险不COVER，有些是DOWNGRADE，牙医那里是这么说的，所以PAY多少
: 比例我都看不出来了。虽然保险说的很清楚（90%，60%等）
:
: balance
: ask
: 60%
|
a*****a
发帖数: 19262 | 5 受到保险公司的EOB，但是通常不包括他们不COVER的那部分哦。
搞不清楚，UPGRADE之后的情况。
may be just a estimation. Once they receive the payment from your insurance
they will adjust.
【在 m**x 的大作中提到】
: You don't have EOB sent by your insurance company? You don't need to
: calculate, it should tell you how much is your responsibility. First bill may be just a estimation. Once they receive the payment from your insurance they will adjust.
|
a*****a
发帖数: 19262 | 6 还有一点，大家没个BILL都会去看一下吗？
may be just a estimation. Once they receive the payment from your insurance
they will adjust.
【在 m**x 的大作中提到】
: You don't have EOB sent by your insurance company? You don't need to
: calculate, it should tell you how much is your responsibility. First bill may be just a estimation. Once they receive the payment from your insurance they will adjust.
|
m**x
发帖数: 8454 | 7 in my EOB I have:
a) amount claimed by dentist
b) amount approved by insurance company
c) amount paid by insurance company
d) amount you are responsible for
d = b-c,
a > b
insurance
【在 a*****a 的大作中提到】
: 受到保险公司的EOB，但是通常不包括他们不COVER的那部分哦。
: 搞不清楚，UPGRADE之后的情况。
:
: may be just a estimation. Once they receive the payment from your insurance
: they will adjust.
|
m**x
发帖数: 8454 | 8 you need to read EOB of course, and know how much you have already paid.
insurance
【在 a*****a 的大作中提到】
: 还有一点，大家没个BILL都会去看一下吗？
:
: may be just a estimation. Once they receive the payment from your insurance
: they will adjust.
|
a*****a
发帖数: 19262 | 9 actually d>b-c
if there is some items not covered by insurance and it always happens to us.
Not sure about it.
【在 m**x 的大作中提到】
: in my EOB I have:
: a) amount claimed by dentist
: b) amount approved by insurance company
: c) amount paid by insurance company
: d) amount you are responsible for
: d = b-c,
: a > b
:
: insurance
|
m**x
发帖数: 8454 | 10 if something not covered by insurance then for this service c = 0, b = a
us.
【在 a*****a 的大作中提到】
: actually d>b-c
: if there is some items not covered by insurance and it always happens to us.
: Not sure about it.
|
a*****a
发帖数: 19262 | 11 I just posted my bill and the statement from insurance company.
can you figure it out for me?
【在 m**x 的大作中提到】
: if something not covered by insurance then for this service c = 0, b = a
:
: us.
|
m**x
发帖数: 8454 | 12 did you see the participant's responsibility in the first form? the last
line, which I can't see clearly. Seems like $137
【在 a*****a 的大作中提到】
: I just posted my bill and the statement from insurance company.
: can you figure it out for me?
|
m**x
发帖数: 8454 | 13 a=401.10
b=263.00
c=126.00
d=137.00
d = b-c,
a > b
you already payed 128.65
so you need to pay the remaining $8.35. however, it does not include the cost of D3120. strangely the first service D3120 is not found in EOB. So you also need to find the item for that. If the dentist did not file the claim for that service, you can refuse to pay the $38. |
