I was having a problem with a tooth that was cracked. I called the office of Michael Waters and asked if they could see me for this problem. They agreed and set the appt. I arrived and gave the Admin Assistant my Insurance card. She commented that I had good insurance and then after verifying, led me into the back to allow the Dentist (Waters) to examine my tooth. He looked in my mouth, took an x-ray, grinded the side of the tooth once, and then he said it needed to have a root canal done by an Endodontist.
I went back up front totaling less than 10 minutes and the Admin made an appt with the Endodontist for the next day. Then she said I needed to pay the office fee of $169 to be reimbursed by my insurance. After paying I left. I went the next day to the Endodontist and had a root canal done. This cost me almost $400 dollars because they referred me to an OUT of Network Endodontist. Had he been in network, I would not have paid anything, the procedure was covered. They led me to beleive he was in network at the time of the referal. I also asked before the procedure was done, and they quoted me $100 dollars after verifying Insurance.
I called my insurance company and they said that there was nothing that they could do. The $169 dollar fee was not fully reimbursed either. I just received a check today for $79.00. It seems they placed a $75 procedure on the bill that said "Emergency Pain Relief" that was not covered. There was no emergency pain relief given to me? He looked in my mouth and I was out of there?
Beware of this Dentist, he does not have a staff that explains what is covered, you are on your own. Don't take anything for granted, ask questions about the bill and get it in writing first. I am sure that he is getting a kick back from the referals. When I called them to ask why they sent me to an out of network Endodontist, the response was, "Well, you were in pain wern't you." Pretty cocky if you ask me.
Stay away from this guy and make sure you contact your insurance company for any questions. I have a PPO, I can only imagine if it was an HMO.