A couple months ago I had some dental work done with dental insurance I had through my job.
After talking to the doctor and being advised to receive some fillers, I talked to the front desk and they disclosed to me the price I would have to pay after the insurance covered all of the costs, it was $350. They did not show me how this was calculated, and I was not told about the total cost before insurance. I was only concerned with how much I would have to pay at the time. I also asked if this was all I would have to pay and there would be no additional charges. They ran my insurance information and told me this is all I would have to pay.
That was ok with me and I proceeded to get dental work done.
For the next few months, I have been weekly receiving an "explanation of charges" letter, saying that I have a "Patient Responsibility" of $1200, and specifically saying "This is not a bill."
I called the insurance company, they were not much help in explaining anything, but they did tell me that charge was a difference between what I was charged and what the maximum insurance would cover.
This made no sense to me, as I previously understood insurance guarantees an "Out of Pocket" maximum, not a maximum of what they would cover.
If this is really the case, and if anyone has had experience with these situations, what advice would you offer in disputing these charges?
Would this affect my credit rating if I wait?
Is this something to take to small claims? What information should I gather in order to do this?
Is there a way to make this a dispute/claim between the provider and the insurance company without my involvement?
In my defense I was given either falsified or misleading information about the charges by the provider and I was charged for something I did not agree to. Would this qualify as a small claims defense, is there a better way to put this into legal terms?