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How much more can doctor charge than the total estimated cost?

South Hadley, MA |

I recently had a gingival graft done. The total estimated price (including the portion assumed to be covered by insurance) was estimated to be $1440.94. The insurance did not pay as much as the periodontal office had expected. Based on the change of the insurance coverage, the surgeon's office is now charging me $2120.00 for the procedure. When I signed the estimate I understood the clause " i understand that this is only an estimate of insurance coverage and is subject to change. I am responsible for any portion unpaid by insurance" to mean that I could be charged up to 1440.94. I didn't think it would mean they could increase the total cost by 46% to 2120. Is this legal to change the price so drastically after the procedure? How can I fight this?

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Attorney answers 2


Your best bet is to get on a payment plan for the bills. Surgery bills frequently run over estimates.

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You need to ask the doctor exactly what is going on. If you believe he is doing something unscrupulous, you should report him to the dental practice Board and ask them to intercede.

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Mr. Lundeen is licensed to practice law in Florida and Vermont. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Oftentimes the question does not include significant and important facts and timelines that, if known, could significantly change the reply and make it unsuitable. Mr. Lundeen strongly advises the questioner to confer with an attorney in your state in order to ensure proper advice is received.

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