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<blockquote data-quote="JimBaw" data-source="post: 2645201" data-attributes="member: 285752">Is it possible to argue the &quot;reasonable amount&quot; healthcare will cover for a......&quot;100%&quot; covered claim? Went to the dentist last month. I was told by our rep that our visits are covered &quot;100%&quot; in and out of network. Knowing I&#039;ll be leaving the network soon (changing to my wife&#039;s plan), I went to a new dentist. Their &quot;reasonable&quot; claim was less than a third of the total bill, and there was a 50 dollar deductible for it that I was never informed of when I signed up. I&#039;m incredibly pissed at the rep for our company (she&#039;s getting a nasty email) because I emailed her to double check about deductibles and additional charges that I could expect if I go out of network for a cleaning, and she just said, &quot;it&#039;s covered 100%&quot; (still have the email actually). While it sucks to pay, it&#039;s not a substantial bill, and I can cover it in my HSA, so I&#039;m not overly concerned, but I am very upset because I feel like I was lied to. Is there anyway you can argue what a &quot;reasonable charge&quot; is? I find it hard to believe that an in-network dentist would charge 88 dollars for something this guy charged over 300 for. To me, 88 dollars sounds comically low. I might as well not had any coverage at all after the deductible was paid!</blockquote>

[QUOTE="JimBaw, post: 2645201, member: 285752"] [b]Is it possible to argue the "reasonable amount" healthcare will cover for a...[/b] ..."100%" covered claim? Went to the dentist last month. I was told by our rep that our visits are covered "100%" in and out of network. Knowing I'll be leaving the network soon (changing to my wife's plan), I went to a new dentist. Their "reasonable" claim was less than a third of the total bill, and there was a 50 dollar deductible for it that I was never informed of when I signed up. I'm incredibly pissed at the rep for our company (she's getting a nasty email) because I emailed her to double check about deductibles and additional charges that I could expect if I go out of network for a cleaning, and she just said, "it's covered 100%" (still have the email actually). While it sucks to pay, it's not a substantial bill, and I can cover it in my HSA, so I'm not overly concerned, but I am very upset because I feel like I was lied to. Is there anyway you can argue what a "reasonable charge" is? I find it hard to believe that an in-network dentist would charge 88 dollars for something this guy charged over 300 for. To me, 88 dollars sounds comically low. I might as well not had any coverage at all after the deductible was paid! [/QUOTE]

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