Saturday, May 28, 2011

Deep cleaning of teeth rejected by insurance but dentist told me prior they would not charge if it was.?

What do you think of this? The dental hygienist said I have pockets in between my gums but I haven't noticed any problems such as inflammation or red gums. My gums are in fact pink and never bleed when I brush them. The insurance recently rejected the claim from the dentist because they said "BENEFITS FOR PERIODONTAL SCALING AND ROOT PLANING ARE ONLY AVAILABLE WHEN THERE IS EVIDENCE OF LOSS OF ATTACHMENT DUE TO PERIODONTAL DISEASE. THE DOCUMENTATION SUBMITTED DOES NOT DEMONSTRATE LOSS OF ATTACHMENT CONSISTENT WITH DESTRUCTION OF THE PERIODONTAL LIGAMENT AND LOSS OF THE ADJACENT BONE SUPPORT. SCALING CALCULUS AND BACTERIAL DEPOSITS" (sorry for the caps it was like that on the website) The dental office told me prior to submitting to the insurance that they would not charge me if the insurance didn't pay because I told them to do a predetermination and they didn't want to take the time. The office manager just said the hygienist would never recommend something that didn't need to be done. It makes me wander about the honesty of the dentist if it was rejected and no evidence was found with what they submitted. Not only that I read most places that a deep cleaning is usually painful and requires more than one visit and mine was done in thirty minutes with no pain at all. I also visited the oral surgeon to have my four wisdom teeth done and he mentioned nothing about infection or gum problems which I think he would of considering he put me asleep to surgically remove my bottom two teeth. He also didn't put me on an antibiotic. The one other problem is they want to put ares-tin in the "pockets" but what also got me is she said we are not going to take care of them all only the couple. She mentioned the pockets were at 4 and five but I dint see any bleeding or pain consistent with that. The last thing is they kept trying to get me to pay for the deep cleaning making excuses for my insurance company not covering it even though my insurance said they would cover it if it was needed. My wife had one done and they did cover it. I brush regularly and floss regularly also. Take care and let me know what you think about this. Thanks so much!
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If the dental office isn't charging you, I'm not seeing an issue. I had a deep cleaning several years ago that did not take hours, nor was it at all painful. Different people experience things differently. If you're having difficulty believing what your dentist's office is telling you, it's time to seek out a new dentist.
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