Is this split billing normal?
I recently went to a new dentist for an exam and cleaning a few weeks ago and I found them through my insurance's website. I asked and made sure that they were in-network before and after the procedure.
I reviewed my explanation of benefits and it turns out they billed my insurance in two separate billings. They only billed the exam portion as in-network and billed everything else (cleaning/x-rays) under another name (practice owner) as out-of-network (about 80% of the total). They claim that the dental hygienist is not in network and needs to be billed with the practice owner's out-of-network Tax ID. As such, it has eaten up about 75% of my out-of-network benefit.
Is this something happens normally? I think that it's a bit dishonest and a bait-and-switch to bill the majority of my treatment out of network and they should have been upfront about it if they were going to do so. The only reason I went to this dentist was to be in-network as I had a new insurance that had a much higher in-network maximum than out-of-network.
Edit: My EOB is billed in the following way:
all with the same date of service in 2 bills
Dentist A (In-Network) - D0150 (oral exam) - plan paid $100
Dentist B (Out-of-Network) - D0330, D0220, D0230, D0230, D0274 (prophylaxis and x-rays) - plan paid $650