Saturday, January 8, 2011

Medical insurance for dental?

The medical insurance company had turned down my medical claim for dental expenses which i had to do in my home country while on my vacation. The insurance company turned down the claim saying that it is not an emergency treatment. But how could severe pain and treatment for Abscess could possibly be NOT AN EMERGENCY..? How could anyone delay or bear a severe toothache for at least a month till returning back to the base country..? My insurance cover is covering the medical expenses only if it is an emergency if treatment done outside of the base country. But they simply turned down the claim saying it is not an emergency. How can i appeal and prove them that this was actually an emergency..?
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The notice you received probably gave you instructions to appeal the decision within a certain time frame. You will probably need a written statement from the provider of the dental service as to the reason why you required dental treatment. Send in your appeal asap. Tell them you have written a request to the dentist for proof that your treatment was an emergency and give them the date of your request. Include a copy of your letter to the dentist with your appeal. Ask the dentist to send the proof directly to your insurance provider; provide him with an envelope and your insurance ID #. Ask him to send you a copy of the letter he sent to your insurance co. so that you'll know that he did so and when so you can follow up with the insurance co if necessary. Give the insurance co two or three weeks to respond to the appeal and the dentists statement before the follow up.
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