Today, my amazing grandparents have been married for 55 years.  Crazy, huh?  Jay & I are headed back to Long Island tonight for a big family party in their honor (103 people) at my aunt’s house.  Hopefully, we’ll have a much better experience flying on JetBlue tonight than we did on Delta 2 weeks ago.  I love my family parties, so although I’m less than thrilled about having to travel again, I’m very excited for the party.

So the latest in the “everything’s a pain in the ass” drama in my life right now involves my dentist.  No wait, FORMER dentist.  I’m going to leave out names for right now because it’s not settled yet.  I will never go back to a dentist I visited in Raleigh in late 2009.  I have Humana insurance through work and let’s just say that you can tell that the choice to use Humana was 100% all about the cheap contract rate they must’ve gotten with them because no one Humana is in-network, as I’ve learned the hard way over the past year.  To preface my annoyance with Humana, in 2009, I had a $500 deductible and in 2010, it went up to $2,000.  Yah.  But Humana’s only half the cause of my newest cause of aggrevation.

I originally went to see Mr. Dentist back on October 8, 2009.  Before going into his office, I asked over the phone if they took Humana.  They told me yes.  I went in for an evaluation and what I thought was a cleaning.  I only got a ton of X-Rays and an evaluation which told me that I had like a zillion cavities (which also really bothers as I don’t chew gum, have cut back a TON on soda & coffee over the last 3 years, and brush/floss regularly – my problem is I grind my teeth a lot).  As a result, I’d need to come back and basically get like $5,000 worth of dental work done.  They gave me a quote based on what they found out when they verified my insurance benefits and I had no reason to believe otherwise.  I found out that day that Humana will only pay for up to $1,000 worth of dental work a year, which also really f*cking sucks.  They recommended that I fix my teeth in groups of 4 and start with the “worst” side, which was the upper right.

After much deliberation and saving up, I decided to have the upper right hand side of my mouth worked on.  3 hours of dental hell on December 8, 2009 and now, on June 4, 2010, I still cannot bite down on the right side of my mouth.  However, I absolutely refuse to go back to that man to fix it for me, for 2 reasons: 1. I have no reason to believe or trust that dishonest practice to not charge me a ridiculous non-covered fee to fix what he and his hygienist messed up and 2. Mr. Dentist didn’t even really give me his full attention during those 3 hours of hell and he left before the procedures were even finished.

So here’s why I’m so angry with Mr. Dentist’s dental practice of Raleigh and the reason isn’t just the fact that I can’t chew 7 months later.  They told me that they took Humana but they didn’t tell me that they weren’t in network with Humana.  They also never bothered to actually tell me (if they even called Humana to verify) that my plan doesn’t cover resin fillings but rather just the silver fillings.  WTF?!  Don’t you think that this is IMPORTANT to tell me?  I paid $370 back in December and suddenly, they want $299 more.  Sure, they have every right to want their money for the services they gave me but they performed those services under a very dishonest and pretty damn sketchy light.  Not to mention that they charge WAY above what the usual & customary fee is for the procedures they did for me.  I always tell patients that come into my office if their product isn’t covered or if we aren’t in network with their insurance carrier.  ALWAYS, ALWAYS, ALWAYS.  It’s just flat out the right, ethical thing to do.  It’s common courtesy of treating people how you want to be treated.  If you don’t want to be taken advantage of by a crooked dentist, then don’t take advantage of your own patients.

After a few months of admittedly avoiding the subject, I set up a meeting with “The Billing Lady” (TBL) at Mr. Dentist’s office on May 12 between 1-2pm.  I went in at 1:30pm only to discover that TBL had decided to go to lunch earlier that day due to someone else being out sick.  I went home for a half hour and returned to the office a little after 2pm.  TBL denied all wrongdoing on their behalf and told me that I should have known that they aren’t in network with any insurance plans.  How would I know?  I’ve never had dental insurance on my own before and dental insurance is way different than regular medical benefits.  Then she completely blamed Humana for not covering the resin.

“Why couldn’t you have advised me that my insurance company didn’t cover that?”

“Because no dentist does metal fillings anymore for cavities.  The insurance companies are the criminals here.”

Finally, she challenged me to call Humana and have them check the recorded phone call from their office on Oct 8 to prove they were totally innocent of being the ones taking advantage of me.  We decided that she was going to file my claim one more time for me.  I know this will not do anything but buy me a little bit more time, but I agreed to it.  I told her that my aunt was entering a hospice that day and that she could call me any time over the next few weeks with the results but please understand that I was on notice to have to fly to NY within 24 hours of whenever she passed away.  TBL and the other girl who sits at the front desk both acknowledged this and told me that they understood.

The real kicker in this story happened this past Wednesday, June 2.  I received an email from TBL at Mr. Dentist’s office telling me that all attempts to contact me over the phone over the last 7 months have failed and if I didn’t pay my $300 bill in full within the next 10 days, they would be turning me over to a collections agency.  I freaked out when I read it.  Obviously, TBL did not refile my claim or really give two flying hoots about trying to help me.  This doesn’t surprise me, as they withheld crucial information to me in the first place, but I was at least hoping that she’d be kind enough to tolerate my frustration as a customer and work with me to at least make me less apprehensive about paying the extra money.

I responded to the email reminding her that we had spoken on the phone a few times and that I met with her in person to discuss the outstanding bill on May 12 at 2pm.  I said that I understood if this was just an automatically generated email that went out to people after a certain period of time, but just the basic reasoning why they were sending my bill to a collections agency (they couldn’t contact me) was 100% incorrect.  I called her yesterday (Thursday) to make sure that she received my email and knew that I was still here and waiting for her to contact me regarding the resubmitted claim.  She told me she didn’t get it.  After some searching, she found my email and told me she’d review it and call me back.  I have not received a phone call or email back yet.

I know that I am going to have to pay this bill ASAP.  I’m just really upset that I got taken advantage of by Mr. Dentist’s office in the first place.  I know now I should have directly asked “Are you in network with Humana?” before I agreed to have the dental work done.  I hate that they didn’t care about me as a patient/customer and that they’re going to win in the end.  So between Delta and the dentist, my summer is going to be incredibly tight.  Oh well, right?