I recently needed a root canal. It was my second and hopefully last. But the invoicing this time was different. My endodontist asked me to pay the full bill up front and then for me to process the claim independently through my insurance and then the insurance company would issue me a check for the percentage they cover.
This is new to me. My previous root canal claim was processed through the dentist and I only paid the co-pays and that endodontist worked it out directly with the insurance company.
Is it a new trend for patients paying the full bill up front even when I have insurance? My regular dentist doesn't do this. I also haven't seen this sort of billing structure in other medical appointments.
The cynical side of me says this is a new way for docs to get more money out of patients. When I look at certain EOBs from other treatments, the doc has a billed price, then there is some sort of negotiated price under that, then what is covered by insurance and then by me. The negotiation occurs between the doctor and the insurance company.
Under this new structure, because I am the one paying the full amount up front, I have the burden of negotiating down the endodontist's rates or negotiating with the insurance company to cover more.
What the heck is going on here?
If relevant, my first root canal was in Illinois and second in Montana. It does not seem to be an issue with my specific insurance, because when my regular dentist was referring me to an endodontist for this lost recent root canal, she mentioned that this was the payment structure of all the endodontists in the area.
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