Late Bill From My Dentist - What Do I Do?

It's common to receive a dental bill within a few weeks of your procedure. Your dentist first has to send a claim to insurance to figure out what they'll pay and what you owe. After that, they send you a bill for the remainder. Some offices even charge upfront.

Sometimes, however, patients get bills long after their visit. Why such a long delay? There are a few potential reasons.

Claim Delays & Denials

After you get work done, your dentist's office will prepare a bill with every procedure you received, and send that off to your insurance for payment. This process typically takes less than two weeks, but certain complex bills can take longer. Claims can get denied due to incorrect information, missing documentation, and a whole number of other errors. Dental billing errors are surprisingly common, so it is not unusual for a claim to be denied and resubmitted.

Office Delays

Your claim might've come back quickly, but your dentist's office might just be disorganized. They might've forgotten to send out a bill to you. Your dentist has no requirement to bill you within a certain amount of time, although they'd rather get paid sooner than later, which is why bills will usually show up quickly.

Failure to File a Claim

It's possible that your dentist simply never filed a claim to insurance, or filed it improperly. Eventually, they decided to bill you instead. This is generally not allowed - there are "timely filing" rules that insurers set with providers. If an in-network dentist does not file a claim within ~180 days, neither the patient nor the insurer owes any money to the dentist - they have to write it off as a loss. For out-of-network dentists, things are a bit more complicated, but some protections still apply. Patients are allowed to file their own claims in case the dentist won't or can't file, and dentists can submit late claims as long as they demonstrate "good cause" (e.g. clerical error, unforeseen circumstances).

What You Can Do

In any case, the best course of action is to get more information. Do not pay the bill without first understanding what it's for, and whether it's correct - you may not owe anything at all. Reach out to your insurer to get an EOB (explanation of benefits) for the bill in question, and compare that to the itemized bill sent by the dentist.

• If your insurer has no EOB on file, then your dentist simply forgot to send one - request that they send it ASAP.
• Check that the EOB and itemized bill match up - are the codes the same? Were you billed at the correct rates?

An unexpected medical bill is the last thing anyone wants to find in the mail. If you're unsure how to navigate the situation, a billing advocate like Slash Dental can help. Slash can request the right documents, analyze them to understand your situation, and resolve the billing issue with your dentist on your behalf. We'll work to get you the most savings possible.

Click to get started, or reach out to us via email at ben@slashdental.com.