Do I take a dentist to small claims court for wrongful billing and sending me to coll

[sergeipdx]

I went to a network dentist for major dental work. they provided me with an estimate, which I signed. They collected my co-pay upfront (approx. $5200). after I got my explanations of benefits from insurance company, I realized I overpaid them by $800. The office wont issue me a refund stating they used "premium" materials. they were forced by my ins company to take write-offs, but still no refund. In addition, after they took write offs, they charged me lab fees in the amount of $1600. Now I am getting letters from them that my account in the collection for a total of $2600. My disputes with the insurance company is in progress, however its ineffective because of all the letter writing back and forth. I tried to call state insurance board and the Florida dental association, they are no help either since they don't handle billing disputes. Should I take my dentist to court since the issue has been going on since the end of 2015 and it has gotten worse because of collections? is it legal in Florida to balance bill if I was using a in- network provider? (The recent changes to statutes only address out of network)

 

[adjusterjack]

You CAN sue your dentist in small claims court.

Whether you do or don't is entirely up to you.

Whether you win or lose is impossible to predict.

 

[quincy]

I went to a network dentist for major dental work. they provided me with an estimate, which I signed. They collected my co-pay upfront (approx. $5200). after I got my explanations of benefits from insurance company, I realized I overpaid them by $800. The office wont issue me a refund stating they used "premium" materials. they were forced by my ins company to take write-offs, but still no refund. In addition, after they took write offs, they charged me lab fees in the amount of $1600. Now I am getting letters from them that my account in the collection for a total of $2600. My disputes with the insurance company is in progress, however its ineffective because of all the letter writing back and forth. I tried to call state insurance board and the Florida dental association, they are no help either since they don't handle billing disputes. Should I take my dentist to court since the issue has been going on since the end of 2015 and it has gotten worse because of collections? I know florida statues prohibit balance billing the patients.

First, the laws you are referencing went into effect in 2016. You say you have been disputing the bill since 2015, before the new laws on balance billing went into effect.

There are two patient service situations when the prohibition on balance billing applies.

Here is a good overview of balance billing, from JD Supra: http://www.jdsupra.com/legalnews/client-alert-florida-what-the-new-14398/

You can try to resolve the billing issue through the voluntary Statewide Provider Health Claim Dispute Program operated by MAXIMUS, Inc.

I am not sure you have a civil action to pursue. You can review the facts with an attorney in Florida.