Dental patients file complaints over COVID fees
Dozens of Connecticut residents have complained to state officials about so-called COVID fees being tacked onto their bills — charges insurance companies refuse to pay.
From Milford to Danbury to Old Saybrook, patients reported fees ranging from $10 to $20 per patient, a review of complaints filed with the state attorney general’s office shows.
In all, state Attorney General William Tong has received at least 28 complaints from patients regarding COVID fees, all involving dentists. The disputed fees add up to just under $500, according to complaints obtained through state Freedom of Information law.
The state Office of Consumer Protection has received three similar complaints.
Tong said COVID fees are not legal if the patient has insurance and pays a co-payment to their health care provider, whether a dentist or another type of doctor.
“It’s not legal to balance bill,” Tong said. “That means you can’t charge somebody more than their co-pay for a covered service. The PPE provided is part of the covered service and integral to the covered service. It’s against the law.”
But, Tong added, if a patient is using a dentist who is not in their insurance company’s network — or has no insurance at all — a COVID fee can be assessed.
Tam Le, president of the Connecticut State Dental Association, said the association’s 2,300 members are aware of complaints and said the association is offering advice over COVID fees.
“The CSDA continues to advise
Connecticut dental offices to check their insurance provider contracts and review the terms of their participation agreements before charging patients for PPE,” Le said.
Lots of complaints
Jan Maria Jagush was not happy when her dentist suddenly began charging $15 for personal protective equipment used to battle COVID-19.
“I didn’t think it was right,” said Jagush, a Danbury resident.
“When I go to a client’s homes for business, I don’t charge for my mask,” said Jagush, who works in property management. “I understand their PPE is more than a mask, but I don’t feel that’s right. It’s part of the cost of doing business.”
Despite complaining to the attorney general’s office, Jagush said she had to pay her dentist’s COVID fee.
The reason: Jagush recently
changed insurance companies and her dentist does not participate in her new insurers network.
“I think people are surprised by these random charges and for some people it’s much more difficult,” Jagush said, explaining that she likes her dentist and plans to remain as a patient.
“For me, it’s a principal issue,” she said, referring to filing a complaint.
Complaints filed with Tong’s office show a pattern of dentists charging COVID fees and that the assessments are not being applied uniformly.
An Old Saybrook dental patient reported being charged a $20 PPE fee, which the patient was told had to be paid by check or cash only.
“I asked for an itemized receipt of this charge and was told it would be mailed to me, but I did not receive such receipt,” the complainant noted. “At the second appointment, I was asked to pay this, but referenced having just paid it at the last appointment, and they waived it.”
The patient added, “I do not believe the recurring PPE fees to be justified. To be clear, PPE was not provided to me during the appointment, but to the staff.”
A Milford patient reported being charged $20 per visit for PPE used by the dentist and office staff.
“I went earlier this year and they did not even tell me,” the patient said. “My wife went for her regular check-up and they charged her as well.”
A Beacon Falls patient said their dentist posted a sign stating the office is charging a $10 PPE fee.
“I called our insurance company (CIGNA) and they told me they do not cover this $10 fee so it will be refused once they receive the claim,” the person said.
A Durham patient said their dentist charged an $18 PPE fee. After informing the office that the charge is illegal, the patient said the dentist waived the fee.
“But I am concerned that they are inappropriately billing other patients for PPE,” the complainant said.
In its own review of COVID fees, The New York Times found an elderly resident at an assisted living facility who was charged a one time, $900 fee for masks, cleaning supplies and food delivery.
Tong said the fees are not fair and can become a financial burden for some patients.
“It can be a lot of money, particularly to people who go more than periodically,” Tong said.
“We are investigating every complaint we get,” Tong added.
“In almost all cases, we reach out to the provider and they stop doing it. We are aware of some health insurers who are paying additional reimbursement to doctors.”
Still, Tong said he understands the pandemic created a lot of confusion, and doctors for the most part are trying to do the right thing.
“Doctors and dentists and health care providers are under a lot of pressure economically,” Tong said. “But that doesn’t mean they can charge more. You can’t pass on your suffering to someone else.”
One complaint filed with Tong’s office alleged that West Hartford Family Dentistry was charging a $10 COVID fee despite the fact that their insurance company was “already covering the entire cost of the appointment. It appears this is ILLEGAL in CT.”
An office manager at West Hartford Dentistry, who did not identify herself, said they no longer levy the fee. “We talked to the state attorney general and are all set with that,” she said before ending the conversation.
Le noted the level of PPE now required is a financial burden on small practices.
“Connecticut dentists, just like other medical providers, are required to follow stricter PPE requirements as a way to limit exposure and the potential spread of COVID-19,” Le said.
The dental association noted that prices for PPE have risen significantly since the onset of the pandemic, in some cases tripling on average.
Surgical masks and gloves have undergone the largest price increases, the association pointed out.