What to Do when Your Doctor's Bill is Too High

If you've ever received a bill that was far larger than you expected, you were no doubt shocked. When that bill is a number with three zeros behind it, it goes beyond shock.

A few years ago, my wife and I visited a dentist that we'd never used before because we had only recently moved back into the Washington area, we were given the shock of our lives. I happen to be blessed with naturally strong teeth; a result of growing up in an area of the country where fluorine occurs naturally in the water; while my wife is one of those people who has more dental problems than teeth. I usually just get a routine exam and teeth cleaning twice a year, while she has to have her bridge adjusted, or have a bad tooth removed, or something equally painful and expensive. I'm accustomed to getting astronomical bills after each of her visits to a dentist, but mine are usually small.

Imagine my shock, then, to get two bills, each for over a thousand dollars, after our visit to this one particular doctor. Complaining to the billing clerk at his office got me a bureaucratic response on the order of "That's what I was told by the doctor, so you'll have to take it up with your insurance company." No amount of explaining that I only got my teeth cleaned; I passed on the dental X-rays at that visit, much to the consternation of the doctor; would get her to listen to me or offer to adjust the bill.

Needless to say, my insurance company was not amused. For nearly thirty years, I have been insured by the same company, and in that time I had never had a dental claim exceeding two hundred dollars for my visits. I submitted my wife's bill as I usually do, and did mine separately, including a letter explaining the problem. A lot of people think of insurance companies, especially health insurance companies, as heartless organizations that delight in denying claims. They did, in fact, reduce the amount allowed for my wife's claim - about thirty percent in fact. No surprise there; we knew going in that most of what she had to have done would only be partially covered.

In the case of my bill, though, they surprised me by responding that they would directly contact the doctor and demand proof of service before processing the claim. They wrote a letter to the doctor, a copy of which was sent to me, outlining my complaint and asking that he provide proof of the medical services provided.

I'm happy to say that this case had a pleasant outcome. It turned out that somehow, my records had been mixed up with someone else with a similar name who had in fact gotten the expensive treatment. The doctor apologized for the mix-up and immediately sent me a new bill; this time for less than a hundred dollars. Well, almost a pleasant outcome; my insurance company would only pay fifty dollars for the teeth cleaning, leaving me to pay the rest. After seeing the first bill, though, I was happy to get out of it at the price. I also came away from the experience with a renewed respect for those in the insurance industry who are willing to treat their clients as something other than a policy number, and an understanding of the need to maintain open, cordial communication with the people you have to deal with in these situations. I also learned the value of being aware of what things should cost. In many cases, the insurance company will pay a bureaucratically determined amount, and the doctor will ask for co-pay, which in this case might have been what I ended up paying any way. But, I knew the charges on the bill I received were outrageous, and signaled that fact to the insurance company. I have no doubt that my willingness to do that had a lot to do with the human response I received from them.