I had a root canal performed, which my insurance paid for, however, when I got the crown put in, BCBS denied my claim saying Insufficient Xrays. I paid my portion of the services, but BCBS refused to pay unless sufficient xrays were sent. My dentist office tried five different times but the claim kept getting denied. I contacted BCBS and they said I needed to talk to the dental office. The dental office said they have tried five times and refuse to file the claim anymore and it is up to me to get the claim approved. Now I am being sent to collections for $350. I paid my part, I want them to pay theirs, but I am being blackballed into paying since no one is willing to cooperate. What should I do?
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You need to clarify with BCBS what they mean by insufficient X-rays? Was it that the X-rays were to blurry to see that the crown and/or root canal was needed to validate paying? Should there have been more X-rays taken to validate, and/or prior and current to prove dental work done was correct. Or it could be that the dentist sent bill, but NEVER SENT ANY X-RAYS at all? You also need to clarify what the dentist office sent to them 5 times? If all else still fails, then file a claim with the state insurance department where you live. When you talk to BCBS, make sure you have a pen/paper ready when you call. You need to ask the person you talk to, their name, ID # plus the date/time that you called. Many times they will deny that they talked to you and they will not note to your record. Also make sure you write down specifically what they need. good luck
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