Why is my bill higher than the estimate?

• Other claims used up part of your annual maximum before this one was processed.
• A frequency limit applied that the office didn't know about.
• The plan paid for a cheaper alternative (an alternate benefit).
• The treatment changed. For example, a filling turned into a crown, or a buildup was needed to support a crown.
• Your plan year reset, or your coverage changed, between the estimate and the treatment.
• You have two plans, and the second one paid less than expected.

1. Ask the office for an itemized bill showing each procedure code and fee.
2. Compare it with your Explanation of Benefits.
3. Ask the office what changed from the estimate.

If you're uninsured or choose not to use insurance, federal rules generally require providers, including dentists, to give you a written good faith estimate if you ask, or when you schedule care at least three business days ahead. If your final bill is at least $400 more than that estimate, you may be able to dispute it.