AmIliable for the balance of a bill if I wasn’t given the correct amount in the first place?

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AmIliable for the balance of a bill if I wasn’t given the correct amount in the first place?

I took my daughter to a dentist and paid the amount they said I owed after the insurance payments. They wanted the payments done before the work was finished. I complied and paid the amount they requested. Now they say the insurance didn’t pay all they thought it would pay and I owe another $341. I don’t have this. What should I do?

Asked on September 29, 2011 under Bankruptcy Law, Illinois

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

You are, unfortunately, probably responsible. As a general matter, patients (or in the case of minors, patient's parents or legal guardians) are responsible for the full cost of their medical care. While, hopefully, most of it is covered by insurance, if it is not, the patient still has to pay; the existence of insurance does not eliminate the patient's responsibility to pay, but merely provides a source of payment. Whatever is not covered by the insurance, the patient must pay for. You can appeal the insurer's determination, of course, if you feel they should have paid more. If the dentist did procedures you did not authorize, or if the total cost (not just your share; the actual cost, including what insurance would pay) was substantially more than you'd been told, you'd have grounds to dispute the bill; but if the only issue is your insurance did not pay all that you hoped, you are responsible for the balance.


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