Do I have to pay dentist for something my insurance denied?

So my friend went to the dentist for a cleaning and was told she needed a crown. She agreed and got it. She then got a notice from her dental insurance saying the procedure was denied bc to be approved, there needed to be evidence that a filling wouldn't fix the problem and it would get worse...more technical than that, but close enough. She called the dentist and they said she had to pay the close to 500 dollar bill. Her insurance told her that the dentist should have gotten pre-approved for the procedure and she didn't have to pay. The dentist is telling her she owes the money and in thirty more days, they will turn it over to collection. Who is right, does she have to pay it, or how can she fight it? If it helps, it's United Concordia, military dental.
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You have a contract with the insurance company. Your dentist has nothing to do with their polices. He was doing what was best for you and what your tooth needed. The insurance company is just trying to get out of paying the claim so as to add to their profit. This is a game they play. There is no legal requirement for a dentist to need approval of an insurance company to do any procedure. The people in the insurance company are not even dentists and wouldn't know how to look at an x-ray. Who do you want telling you what treatment you should have? Your gripe should be with the insurance company rat finks and not with the dentist. You will need to pay the dentist and fight with them.
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If my dental filling fell out, do I need to be concerned for my internal health?

Today, my stainless steel crown covering a filling that was done over 10 years ago was pulled off by a taffy piece of candy. I won't be able to see a dentist until I can get my insurance figured out, which could take WEEKS. Because of the exposure of the inner filling "stuff," do I need to worry about getting sick?
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Yes - infection can set in. It also exposes the tooth to further damage causing possible loss. While what the first responder said is true, that should only be a temporary fix. Dental diseases can lead to other health problems if left unchecked. Go to your dentist and get it fixed - fairly simple procedure to replace a filling and not that expensive. However, the longer you wait the more difficult and expensive it becomes (fractured tooth, root canal, etc) to fix.
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If an insurance company pays for an injury they are liable for, how long will they continue to be?

My son was hit in the mouth with a baseball seven years ago. His teeth had to be wired in place. One of the four damaged teeth was worse than the others. That one required a follow up root canal. The baseball insurance covered all expenses as we were uninsured at the time. Now, 7 years later, the tooth that had the root canal is still deteriorating, and we just had to extract the tooth and in 6 months will be doing an implant (after the healing completes itself). We do have dental insurance, however, it will only cover less than $1,000 of the costs. The total bill is going to be close to $7,000 or better. I feel the insurance company should still be liable to help with the expenses. The company says they only are liable for 156 weeks. They never told us that before. What can be done? We are not asking for pain and suffering (although with the pain he has been through, we SHOULD).
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I am sorry to say this, but think about it, how long is this insurance company supposed to be on the hook? For 156 weeks, that is over 3 years. You could go to the dentist for the next 20 years and provide a bill and expect them to pay it. Would you do this? Pull out the paperwork you signed. (Believe me, you signed it and most likely then not read it, or was told they would cover, but did not HEAR that it was for X and X amount of months). You were just happy they covered it and would pay for any other problems. As for the dental implant, that appears pricey, I have seen that the average is around $3,500, based on my own experience of doing claims. My suggestion is to call the dental schools where you live. Many will do procedures for over 50% less than a licensed dentist since they need the experience and have licensed dentist to oversee the procedure. Also, since you have dental insurance, see if they can find a dentist to do. Even though a dentist charges say $2,000, the contract with the insurance maybe they will allow only $1,500, meaning you would owe only $500. good luck
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What can I use/do to make me teeth stronger?

I chipped one of my front teeth while eating a cob of corn and now it hurts alot to bit on anything with my front teeth...that one in particular. Going to the dentist is not an option at the moment as I do not have dental insurance or enough money to pay him.
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if u brush ur teeth more than twice a day, u should lower that and wait for ur enamel to get stronger... also, if ur using whitening strips, that could be why. when u brush ur teeth, brush up and down, not side to side. :)
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Question for DENTAL people?

How can I find a dentist who will do just a cleaning? I don't have dental insurance. I pay cash or check. I'm an easy customer. My teeth are in decent shape. In and out. ALL I want is a cleaning. My last dentist installed laptops in each hygenist area to quickly book additional appointments for additional mouthwork while the customer is in an awkward position on the chair. They were very nice people ten years ago. Now, they've grown quite ugly in their relentless push for selling upgrades. It took me a while to recognize that my "friends" at the dentist have gradually gotten meaner and greedier. I was actually getting scared on my last visit. Gentleness with the tools seemed to have disappeared. I understand they have bills to pay, but I don't want to have to fight to keep my $85 cleaning charge from ballooning up to $350 for all kinds of stuff I don't want. I did find a place, but they said the dentist will have to look at me first. What is that going to cost? I just want a cleaning. What is so hard about that? Any ideas on finding a dentist who will just do a simple, fair-priced cleaning? Thank you.
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They will recommend certain procedures because by law they have to. But you have the right to refuse services. But if they have to do an exam or xray first, then they must to protect themselves from any lawsuits and/or damage to a persons oral health. You could get an exam one day then 2 weeks later get an xray, then 2 more weeks later get a cleaning. Spread out your money so it does not have to be a lump sum. Maybe this site can be of good use to you: www.healthsavings.ourperfectcard.com I signed up online over 5 years ago now and they have saved me thousands of dollars over the years on all services. My benefits were even active in 2 hours and was able to use them the very same day.
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Are discount dental plans/fee schedules really beneficial?

My family does not have dental insurance, and I am going to need some work done. I have some issues with my gums, and it has just been years I've been to a dentist. I've been looking online at a few discount plans, but I'm just wondering if they are actually beneficial. For my whole family, it would cost $160-$200 a year. I called a dentist's office that is listed and they said their normal cost for a crown is around $900. With the plan, it would cost $504. Has anyone actually used any of these discount plans? Please don't advertise your own website here. If you are a broker or whatever looking for business...look elsewhere please. I only want to hear from people who have actually used these plans or from someone who works at a dentist's office and knows how these plans work. Thanks!
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My advise to you is that dental plans are basically very costly and do not provide good value. In regard to your gums, I strongly suggest you do an alternative, low cost thing that will reap you great rewards. Go to: (800) 370 - 3447 and order two things: Neem Oil Neem Bark Mix these two items together and make a paste. Put the paste all over your gums first thing in the morning and before bed. It takes ONE day to stop all bleeding. You can reduce dental pockets and as bad as a grade 5 pocket within less than 2 months doing this. Your gums will become healthy. This will save you thousands of dollars alone. The next thing to do is to fix your diet that is causing the dental problems. I strongly suggest you seek out a Certified Nutritional Therapist that can advise you. They can test you for nutritional deficiencies and recommend supplements and a good diet that will put you on the road to health that will keep those teeth looking good. good luck to you
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How much do partial dentures cost?

My boyfriend got into a car accident and got teeth knocked out. He's going to need 2 teeth pulled and a total of 4 teeth replaced. How much do you think this will end up costing? I am asking because he has no dental insurance.
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Probably about $1000-$2000 depending on what type of partial it is.
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Care credit/dental work?

Hello! I'm going to need to have all 4 of my impacted wisdom teeth taken out within the next month or so. I have basic dental insurance with MetLife through my employer, but they do not cover any part of the wisdom teeth extraction procedure. None of the oral surgeons in the Minneapolis/St. Paul area will allow me to make payments, but they will let me use care credit. I have heard many mixed reviews on Care Credit. Several people say that they were slammed with unknown fees, late fees (even when they weren't late), they weren't allowed to make a payment bigger than the minimum, and other horror stories. My question is...do you have any suggestions for me? I don't have the cash to just hand out to the surgeon upfront. Could you please tell me about your experience (good or bad, please!) with Care Credit. Thank you all so much!
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They not good, they dont pay out well
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Wisdom teeth removal, no insurance, unemployed, inexperienced. What to do?

I'm in my 20s and I have only had insurance through my parents and work in the past. I am currently unemployed, and uninsured and I don't have a dentist. Unfortunate timing for wisdom tooth pain! I really don't know where to start in my quest for relief. I'm getting really confused trying to research dental insurance, dental plans, dentists. I don't know what point to start at! I don't even care if I'm covered for long, I just need help getting all four of these teeth extracted ASAP, they are killing me! What kind of plan or even specific company do you recommend in this situation if you've been here, if you think you have good, informed advice?
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You can easily check your minimal health care rates in internet, for example here - health-quotes.isgreat.org
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How much will braces cost me?

I'm 14 and i do not have dental insurance through my moms work. I just had a gap and an overbite
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got mine a year ago, my insurance did not cover any of it either. When its all paid and done, they will have cost me $ 5400.00. Let your mom know, most ortho's do offer payment plans! GL
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What would you prefer, a Government Run free Dental program or black and missing teeth?

All because the insurance companies have priced MOST of us out of coverage.
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A government run free dental program, obviously. I think all dental care and medical care should be free. The advances made in these fields are gifts to humankind, and money should not enter into them in any way, shape, or form. The poorest of the poor is just as deserving of dental and medical care as the wealthiest. Dental and medical insurance should be UNNECESSARY.
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Is medical Insurance Worth it? (See Below)?

I am a recent grad and on my first professional job. I'm 23 years old. I took out medical and dental insurance. I don't have any health problems. Neither does my wife. We took a physical and was told to be OK. I did some dental work but my teeth are overall OK. I pay 162 a month for dental and medical when i can possibly put that money to other uses. I was thinking you know those clinics or if we must visit the emergency room it probabaly would come out cheaper.
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Basically you're saying you want to forgo medical insurance and use so-called "free" care. That's bad - bad for you, and bad for everyone else. It's bad for you because you will not get preventive care or any kind of care that is not emergency or minimal triage. Sure, the free clinic will treat your pneumonia, but it won't help you with high blood pressure, for example. There's a difference between "treatment" and "health care." It's bad for everyone else because you are a professional who CAN afford to pay his own way, but chooses instead to freeload on the backs of others. Not cool at all.
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I have some grayish stains on my gums near my front bottom row teeth?

I have no health insurance/dental insurance so I can't really go to the dentist. I am kinda worried that it could be something serious. I am a smoker but I brush my teeth twice a day though I am sure that probably does not help much. Any advice on what I can do or if low cost dental clinics exist so I can get them checked?
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if this gray-color is on your gums and not your teeth... it can be from a variety of things - from gum disease to oral cancer. I'd do one of two things if i were you (or 3 if the first 2 don't work) find a sliding scale dentist office ($20-$35) or go to a sliding scale medical doctor is they have been in your mouth/on your gums for more than 2 weeks.... same sliding scale if you search your area under sliding scale medical walk-ins. or 3 - go for a "Dental Consultation" - many many of them are FREE. Have them look at your teeth and gums, ask the dentist if he suggests any work ups, does it look like cancer, or gum disease, or just stains! Get all the freebie info you can get out of the consultation. But truly - You really Need to See a Dentist/Doctor - This is the case anytime a sore is in the mouth or ON an area of the Gums. For notice whenever we bite our lip a little or inner cheek? - those sores go away much faster than 2 weeks. So it is standard medical advice that anything Longer than 2 weeks to heal and/or looks suspicious - See a Doctor. You don't want to take any chances with this one. Even though it is probably nothing - it just might be something. So please, DO something ok? and If money is Super-Tight... Do the Consultation, walk in like you're full of money and you'll get more of their time. Sounds terrible, but your life is worth it.
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College insurance question?

If im currently taking a 13 credits and i drop a 3 credit class to drop to 10, will i still keep my health/dental insurance because i attempted 13 credits which is over the required 12 for a full time student, or will i lose it because i fell under 12?
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I've never had this problem, but recently at college my friends wanted to drop a class, but they were only taking 12 credits so they couldn't withdraw or else they'd be dropped from their insurance, so they're stuck taking it :/ I would contact the insurance agency or look on their website. On my policy, it says pretty clearly that if I EVER drop below 12 credits/"full-time" status, I'll be dropped.
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College insurance question?

If im currently taking a 13 credits and i drop a 3 credit class to drop to 10, will i still keep my health/dental insurance because i attempted 13 credits which is over the required 12 for a full time student, or will i lose it because i fell under 12?
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College students have enough to think about with class schedules, studies, social calendar, and work. Maintaining such an active lifestyle requires a healthy body. Good health and wellness is critical to a successful college experience and essential for maintaining the focus necessary to meet the demands of today's college curriculum. For most students, college is their first independent living experience. The first rule of living independently is taking care of yourself. The last thing you want to compromise is your health. Health Insurance is the first step! We have established a variety of health insurance options with strong, reputable health insurance carriers
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Racism in Orange County in the Dental Practices?

I'd visit a dental office located in Laguna Niguel www.aestheticdentaldesigns.net called the office and explained to the office personal that I was just released from the Mission Hospital ER and I was suffering from servere tooth pain and was told that I needed a root canal from the ER Physician. I asked the receptionist over the phone if the dentist specialized in root canals and the office gal put me on hold, came back to the phone and stated yes that they specialized treating patients with root canals, she went on to say, if this is an emergency that I can be seen the same day. When I arrived to the Dental office, the appearance of the office looked very exotic with a fancy construction build out something that reminded of a Star Trek movie. I'd notice the Dentist running around in the hall way making copies of documents while I was being entertained by his staff. I was called into a room 20 minutes from waiting in the lobby for X-rays. The technician asked where was I experiencing the most pain and she took X-rays of just three teeth and not the full mouth. Within 35 minutes, the second gal who was the receptionist walked into the room. Before any treatments or X-ray explanations she begins a sentence with "She did not know what I could afford?" Apprehensively , she begin explaining the findings of the X-ray taken of the three teeth, however I could not understand what she was trying to convey because of her lack of experience reading X-rays. After not understanding the receptionist I'd demanded to speak to the dentist. The dentist finally walked into the room 25 minutes later with a nasty deposition and handed me a flyer of an African American boy who died of rotten teeth. I begin asking questions about the findings of the X-rays, and the dentist responded with a nasty smirk; his actions gave an impression as if he didn't want to treat, or touch an African American. He went on to explain the X-rays, and suggested that I should seek another dentist for general treatments and recommended that I should see a dentist that specialized in root canals. I'd asked the dentist for a prescription for pain the dentist in return begins to ask allot of unusual questions as if I was a street person who was a drug user. He hesitated to write the prescriptions and stated that he doesn't get involved with giving patient prescriptions to medications. He continued to push the flyer in my face of the African American boy who died of rotten teeth because his mother could not afford dental insurance. The dentist went on to say that I would need a crown after the root canal and can be seen by any dentist! I begin asking the dentist about his fees concerning crowns, the dentist assumed because I was African American that I could not afford his dental services and printed an extra nominal fee of $2,200 per crown. His office charged me a consulting fee, close to $200 bucks for No treatment and phony Xrays.
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well they sound very unprofessional and would be wise to not go back to them fools, but why would you goto an ER for tooth pain in the first place. hmm
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Would insurance cover invisalign?

We have blue cross blue shield dental insurance
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Most insurance companys do if you have ortho coverage so i would call your plan and ask them or else your dental office should be able to let you know also.
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Where can I find a dental surgeon?

I Need a dental surgeon who can work with me I do not have insurance at this time and I am in pain, I have a cracked/ broken wisdom tooth that is in severe pain... I have no insurance through my job and cannot afford to purchase insurance. Is there a place I can go in Houston TX that can help me before this gets too bad????
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The University of Texas Health Science Center in Houston has a dental branch. The phone number is 713-500-4000. At a dental college you can get excellent treatment at very low cost, sometimes you only pay for materials used. All treatment is overseen by an instructor. I have used the one near my home several times before I got dental insurance. They sometimes have a pain clinic so try giving them a call.
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orthodontist insurance?

I want to get braces, My teeth aren't that bad, all I have are about 3 minor gaps on my upper row, and 2 small ones on the lower teeth. I haven't been to a dentist to have a consultation or anything yet, but judging by looking at friends who have had braces, I couldn't possibly need them for over 2 years. I also don't have dental insurance, but plan to get it before I go for my first orthodontist consultation and all. I just wanted to ask people on here how much do you think I could save having dental insurance, (percentage wise), and for suggestions for a good dental insurance plan in your opinion that you've tried. And maybe an opinion, of how much without the insurance would regular metal braces would cost in total. I'd especially like to hear from those of you who has had them before and your positive or negative experience from braces,how long you've had them, what your problem was and how your felt about the final results. Thanks
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My husband had braces for over 4 years because he didn't follow the orthodontist's instructions. If your teeth aren't too bad then I wouldn't imagine you would have them on near this amount of time....just do what you are told to do with the care of them!! Insurance can be pretty pricy so make sure to do your homework to see how much will be covered and if it is worth it to take the plan. Another alternative is a dental discount card. You will pay $11.95 a month and it will provide you a discount at participating provider locations. Just make sure to verify provider participation in your area before applying. Here is a link that you can explore: http://www.mybenefitsplus.com/40491833 If this is for you then just click on Join Now and you can go to the dentist the same day.
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Serious dental problem?

I am 23 years old, and a full time student who works part time. I have been without dental insurance since I was 11, because it is just too expensive. For the past few weeks, my mouth has been hurting very badly. I went to see my school nurse today, and she said I have an impacted molar coming in, and I better get to see a dentist soon, or I was in for a world of pain. She gave me a list of dentists to call, and none of them will see you unless you can pay the full amount up front. I can't do that, I am a full time student and I have rent to pay. Does anybody know of any service in Florida that will help people who cannot afford dental care? I am at my wit's end and do not know what I can do. Help!
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Hey what part of Florida are you in? I am in Melbourne. I'm sorry to hear that you are in so much pain. You should always have your wisdom teeth taken out because when they start to come in they can cause your other teeth to shift and move because most people to not have a large enough jaw to support them. They are also so far back that it is hard for you to keep clean so that makes it easier for them to get infected. You should look into any dental schools in your area to see if they can see you. They will be alot cheaper than going to a private practice. Also look into any free clinics in your area and see what they offer. They could probably tell you who you could see if they cannot do anything for you. Good Luck and I hope that you feel better soon.
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Wisdom Teeth/Biting Cheek/Extraction/Insurance?

So my wisdom teeth have been growing lately & now my lower right one is partially out and my upper right one is completely out.. I notcied that when I chew, my wisdom teeth bite my cheek and I have to be very careful not to hurt myself. I was wondering if you could have your wisdom teeth pulled for this reason alone (there's no impacted molar or anything, that I know of), and would dental insurance cover it?
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Your dentist can recommend the removal of your wisdom teeth and have the dental insurance pay for the cost without there being an impaction or infection. In your case, yes the biting of the cheek is enough to suggest they haven't erupted correctly and need to be removed. In fact, the sooner you have it done the easier it will be to do the job. The wisdom teeth do not have roots into the jawbone for the first bit after they erupt, which makes removal much more pleasant to recover from as well. They can be removed with just a local anesthetic, and not require an oral surgeon or sedation. My daughter had the same problem and had hers removed as well. The insurance paid for it. She had the teeth removed in the morning, and was out with friends at the movies that evening. She had to leave the popcorn and soda alone, but otherwise she was on full feed and did great. Just go see the dentist as soon as you can get in, and arrange for the removal. The folks in the business office can help with the insurance arrangements. Good luck, and don't worry. If they aren't infected or impacted, removal is usually not that bad.
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What is the best company for small business health insurance?

I have a small business and want to offer my employees medical, dental and vision coverage. What is the best health coverage company to go with. I live in california and my business is in california. I have a corperation...and want them to have a nice copay, like $10.
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I recommend you this site where you can compare quotes so you can find the best option for you http://cheapinsurance.notlong.com
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How harmful are dental x-rays? Is it bad to get more than one done in a month?

I haven't been to a dentist in a very long time since I don't have insurance I just kept putting it off...I decided to get a checkup this month and had dental x-rays taken. Well I really didn't like the dentist office I went to, so I decided to go another dentist office about a week later. The other dentist I went to took dental x-rays as well. I need a root canal and both dentists were charging amounts I couldn't afford, so I decided to look for dental insurance. I have qualified for dental insurance beginning next month, but it's HMO so I have to go to another dentist...which happens to do digital x-rays only. Now I'm afraid that too many x-rays within a short period of time might be harmful. I just read an article on msn about new studies show that x-rays causes cancer in the future. I'm not sure what to do...or if dental x-rays are not that harmful... anyone know??
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You were harming your body more by putting off much needed dental work. Broken down, decayed teeth, bleeding diseased gums, infected teeth that need root canals are more dangerous to your overall health than a few x-rays per month. Dental offices follow strict protocols for radiation and how much exposure a person can have. I assure you that you are safe, esp with digital x-rays, which produce 60 to 80 percent less radiation than traditional films. Also the beam of radiation is so focused, in this case on your mouth, that the exposure to the rest of the body is minimal. Periodontal gum disease, decayed teeth, and infected teeth and gums produce inflammation in the body, which has been connected to an increase risk of strokes, heart attacks, miscarriage in pregnant women, diabetes........ the list goes on. Are you aware of how much radiation you are exposed to in a day? The sun, computers, microwaves, etc. Dental x-rays are an absolute necessity for the dentist to properly diagnose your dental problems. Dentists can get into serious trouble if they work on a tooth for a filling or root canal without an x-ray. Your best bet is to educate yourself, and stop believing everything that you read, including this post. Don't take my word for it, ask your dentist, find research at your local library or university, be proactive. As a side note just about everything that we ingest, are exposed to, work with etc has been reported as a possible carcinogen. With all of the pollutants in our air and water, preservatives in our food, lead paint on our children's toys, how is anyone ever sure what exactly causes cancer, the answer is no one really knows FOR SURE!!
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