Hospital Fees for Dental Work

Our dental covered anesthesia but it was done at a dental office. It is alway important to check with your insurance before so you know what they will cover. Also, it may simply have come back on you because of the amount. Our dental will cover a lot, but only up to $1750 a year, anything over that, no matter what it is, is not covered. They may have said yes, they would pay for the hospital, but it is up to you to know the amount of your benefit per year. My son just had 6 teeth pulled and a space maintainer put in, and even thought it was all stuff our insurance covered 100% we still paid almost $1500 out of pocket because they will cover 100%, until that $1750 is spent, and then cover nothing until the next year. and I don't know any dental plan that would have a benefit high enough to cover 9k. I know when my step dad had dental work done in a surgical suit he had to pay for the room out of pocket, but I don't know what kind of insurance (if any) he had at the time.

People keep talking about some preauthorization forms, but that is never a guarantee of coverage. If you look back at the billing they gave you before the procedure you will more then likely see a part on the form they had you sign before stating that they will bill insurance, but that any unpaid part is your responsibility. It sucks, but more then likely you have no real recourse. We have found out the hard way this year about how dental insurance works and how little they really cover if something major needs done.

Ask your dentist to produce the pre-authorization they received from your insurance. This is ALWAYS done in writing. ALWAYS.
If there is a written authorization that your dentist can give you a copy of just send it in and request that they pay. Sometimes in those big insurance companies the left hand doesn't know what the right hand is doing.

If there is no email or letter from your insurance stating that they will cover the cost your dentist has lied to you.
If that is the case and you have ANY written documentation (even an email) to prove what they told you, you can try to fight the charges.
If there is no documentation and in addition they probably made you sign that you would cover all the charges that your insurance didn't pay for, there is not much you can do. Maybe you can arrange for a payment plan...

This is an expensive lesson learned: always, ALWAYS ask for a written document from your insurance company that whatever procedure is done will be covered!
Good luck.

We have not had any dental work done at the hospital but it is well known that All anthesia, labwork, etc are billed separately to you.

Dental coverage only covers dental work.

Ask your insurance if this can possibly be covered under your medical insurance but my guess is no. There should have been specific follow up regarding all coverage and what would be paid before the procedure.

Dental insurance covers dental issues. Health insurance usually only covers dental procedures if they are as a result of a congenital condition or an accident. Most dentists will do a pre-authorization request and submit to the insurance company in advance to see what they will pay. My dental insurance company sends me a copy of their determination of benefits too. Ask what authorization the dentist received and ask for copies of that paperwork. Then resubmit it to your insurance company. If they approved part of the procedure, then they will pay or you will have to appeal. If the dentist didn't submit request in advance, I would be very upset with them. Good luck. Every policy is different, so you really need to know what your policy covers.

Dental work is separate from the use of the hospital, you're paying for them allowing your son to be worked on there. The doctor may have indeed received authorization from the hospital to use their facility, (your wording), but that has nothing to do with it being covered by your insurance.

Unless your policy states they will pay for use of a hospital when undergoing a dental procedure they not obliged to cover it. You need to know what your policy specifically covers. My BIL's insurance, a great one, also doesn't cover anesthesia for any reason, so before procedures and surgery they need to pay the anethesiologists in advance. Apparently the policy would cost much more if it was covered, so the employees work with it. And they also don't get coverage for the use of a hospital in a non-medical procedure. But he and my sister know this.

You should have received a copy of the approved authorization from your dentist, if not ask for a copy. If your insurance is now billing you for the money I'm guessing they initially paid it? If so ask why. If it's the hospital billing you try to work out a payment plan, they might get nasty but the bottom line is they want their money and will take what you give them each month. Legally, if they accept anything as payment on a regular basis they cannot sue you, though they might threaten, the judge would see you're paying and toss their case.

There is a reason there is mobile anesthesia. It will not be covered.

sorry for the brevity I'm in my car

Sorry about that. I not only work for anesthesiologists but my son needed anesthesia for some dental work when he was young. Most insurance companies will not cover anesthesia or anything that has to do with it. Clearly if you didn't have anesthesia you would have been in the dental office. That is what they look at.

We have six mobile anesthesia vans that do nothing but travel to dentist offices. Reason being the patient only has to pay for the anesthesia.

I really am sorry this happened to you. This is why you always confirm coverage with your insurance company, not the doctors.

My son had dental work done under general anesthesia, but it was at the dentist's office (not the hospital). We knew our dental insurance wouldn't cover the anesthesia, so we submitted it to our health insurance. At first they denied it, but then after our pediatrician and dentist both submitted letters to the health insurance company stating that they both recommended the general anesthesia due to his high anxiety in the dentist's chair and his young age (he was only 3), the insurance company ended up paying for 1/3 of it. It still cost us a fortune, but we were happy that they eventually paid for some of it. Anyway, might be worth asking your dentist AND pediatrician to advocate on your son's behalf by submitting letters stating the reasons why anesthesia was needed & recommended. Good luck to you.

From my experience, the medical claims that aren't covered by your dental should be sent to your medical insurance.

We just got our bill. Kaiser paid the $600 for the anesthesiologist at the hospital and we owe nothing additional (other than what we agreed to at time of service). DD's teeth were done April 1. We were notified that the dentist had requested pretreatment permission from the insurance and we also had a written estimate we signed based on their fees, our insurances (dental and health) and what we were required to pay. Did you get anything like that? Her medical insurance covered the anesthesia and the dental insurance paid for the actual dentist.

If the dentist coordinated with the hospital, I would start there and ask them if there was any pretreatment paperwork that was not filed. Nine thousand is quite a lot.

Do not pay this. Find out what is going on and who dropped the ball.

ETA: Treatment may vary but the TOTAL cost for my DD's teeth, including all the hospital fees, was less than $2K (most covered by our insurance), so $9K from the hospital is something you need to get to the bottom of.

Did you check with your insurance company before going this route. If you did not, I think you will be out of luck. You always need to get confirmation
Yourself. Do not take anyone's word. Get names and everything in writing.
Dental cannot be submitted to medical insurance. Hence medical and dental are two very separate policies.

bet the price is jacked up due to being 'billed' as self-pay ... they aren't sure if they'll get much, if any, of the money

(say this cause of the amount they plugged across my credit card when I was paying to get my granddaughter's broken arm set and case - double bone break -- at the end, the overall bill was about half the hold on my credit card, but I pushed thru all paperwork quickly so the daycare insurance covered it)

GOOD LORD! It's not near that expensive. There is definitely something going on here.

Our insurance covers it just fine! They kids go to the outpatient surgery center at Children's Hospital in OKC and the anesthesiologist comes in and talks to us about the meds and stuff then goes on her way. Dr. Lee comes in and checks to make sure stuff is going okay then the kids go off in a few minutes. They come back just a bit later after all the work is done.

We never got a separate bill from the hospital, it was all billed through the insurance and they paid it. There's no way it's $9000 for just anesthesiology, that's crazy.