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Can my orthodontia provider legally take my claim payment?

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I am currently getting Invisalign treatment through an Orthodontia Provider in California. I paid for the treatment up front at $3,000. I was told by the provider that it was unlikely that insurance would cover any of this. A few months into the treatment, I checked with my insurance and discovered that they do cover this.

When I called my provider, I was told that they would file the claim and it would take 6-8 weeks for me to receive a check. 7 weeks later I called my insurance and discovered that they had the payment sent to them and it was electronically deposited immediately (7 weeks ago)! When I called my provider and asked why it would take 6-8 weeks for me to receive a check, they said "Management has to approve it". This honestly sounds very sketchy to me and I'm worried I will never receive my claim payment.

So two questions:

1) Why would an Orthodontia provider want to receive this payment at all in the first place? I was thinking maybe tax reasons.

2) If they never end up sending me the claim refund, do I have any legal power to fight against this? I have all of the original receipts and an EOP report.

contract-law insurance medical

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asked 5 mins ago

Charlton ProvatasCharlton Provatas

101

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Charlton Provatas is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
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0

I am currently getting Invisalign treatment through an Orthodontia Provider in California. I paid for the treatment up front at $3,000. I was told by the provider that it was unlikely that insurance would cover any of this. A few months into the treatment, I checked with my insurance and discovered that they do cover this.

When I called my provider, I was told that they would file the claim and it would take 6-8 weeks for me to receive a check. 7 weeks later I called my insurance and discovered that they had the payment sent to them and it was electronically deposited immediately (7 weeks ago)! When I called my provider and asked why it would take 6-8 weeks for me to receive a check, they said "Management has to approve it". This honestly sounds very sketchy to me and I'm worried I will never receive my claim payment.

So two questions:

1) Why would an Orthodontia provider want to receive this payment at all in the first place? I was thinking maybe tax reasons.

2) If they never end up sending me the claim refund, do I have any legal power to fight against this? I have all of the original receipts and an EOP report.

contract-law insurance medical

share

asked 5 mins ago

Charlton ProvatasCharlton Provatas

101

New contributor

Charlton Provatas is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
Check out our Code of Conduct.

add a comment | 

I am currently getting Invisalign treatment through an Orthodontia Provider in California. I paid for the treatment up front at $3,000. I was told by the provider that it was unlikely that insurance would cover any of this. A few months into the treatment, I checked with my insurance and discovered that they do cover this.

When I called my provider, I was told that they would file the claim and it would take 6-8 weeks for me to receive a check. 7 weeks later I called my insurance and discovered that they had the payment sent to them and it was electronically deposited immediately (7 weeks ago)! When I called my provider and asked why it would take 6-8 weeks for me to receive a check, they said "Management has to approve it". This honestly sounds very sketchy to me and I'm worried I will never receive my claim payment.

So two questions:

1) Why would an Orthodontia provider want to receive this payment at all in the first place? I was thinking maybe tax reasons.

2) If they never end up sending me the claim refund, do I have any legal power to fight against this? I have all of the original receipts and an EOP report.

contract-law insurance medical

share

asked 5 mins ago

Charlton ProvatasCharlton Provatas

101

New contributor

Charlton Provatas is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
Check out our Code of Conduct.

share

asked 5 mins ago

Charlton ProvatasCharlton Provatas

101

New contributor

Charlton Provatas is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
Check out our Code of Conduct.

share

asked 5 mins ago

Charlton ProvatasCharlton Provatas

101

New contributor

Charlton Provatas is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
Check out our Code of Conduct.

asked 5 mins ago

Charlton ProvatasCharlton Provatas

101

New contributor

Charlton Provatas is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
Check out our Code of Conduct.

asked 5 mins ago

Charlton ProvatasCharlton Provatas

101