A state worker called Kurtis when her insurance statements didn’t match up with her dental bills. She’s a tax auditor, she crunches numbers for a living. So, when her recent insurance paperwork showed up, she soon found the math didn’t make sense.
“Check your claim forms,” said Johnell Wilson.
That’s something she wishes she would have done earlier. Because after her latest trip to Scripps Dental Group, in Sacramento, she suspected her family has been getting overcharged.
“The way that they would bill you is they would give you an invoice the day of the treatment and they’d call it the estimated patient’s portion,” said Wilson.
The first bill she questioned was after a recent visit to Scripps. It showed on that particular visit, after insurance the amount she should have owed her dental provider was $312. But Wilson actually paid Scripps $876, a $564 difference. And when she added up all of her and her husband’s bills over two years, she suspects they overpaid $994.
“I think it’s really shady, I mean, the way that they handled it,” said Wilson.
She called and emailed Scripps, demanding a refund.
“She said to file a grievance with our insurance company, and to dispute the charges on our credit card,” said Wilson.
“Don’t accept a bill from a provider without double-checking it,” said Amy Bach, executive director for United Policyholders, a non-profit consumer advocacy group.
Bach says if you ever have a problem with a health bill, your insurance company should go to bat for you.
“You don’t have any leverage as an individual consumer, but the insurance company has a lot of leverage with a provider, with regard to their billing,” said Bach.
Wilson did file a complaint with her insurance, but after telling Scripps Dental she called us, they sent her a check for the $994.
Scripps couldn’t explain to us why she was charged more, telling CBS13 the new owner as of Jan. 1 has taken care of previous owners’ patient refunds.
It is standard for dental practices to require prepayment for any services rendered. More often then not, the insurance company does not pay what was estimated and the office writes it off and does not bill the patient.
Scripps Dental group had a complete audit and evaluation prior to securing the loan to purchase the business.
-Cindy Merila, Scripps Dental Group
But Wilson says that hasn’t necessarily restored her faith in Scripps.
“I’m going to have to look for a new dentist,” she said.
We contacted Wilson’s insurance company. They couldn’t tell us whether they were investigating Scripps further but say they do have protections and procedures in place to review payment discrepancies.