7 months ago I went to the dentist and I had a tooth that needed a peridontist to do surgery on. I went to the peridontist about 4 months later, had an evaluation, and later had the surgery. The insurance paid 80% for the service as promised. Then a month ago I had my 6 month check up, which the insurance only paid a fraction of. I have had this insurance and this dentist for years and haven't had to pay for check-ups so I called up the insurance to ask why. They said part of the claim was called an evaluation and I had an evaluation less than 6 monthes ago. I assured them it had been over 6 months since I'd been to the dentist and they said it was with the peridontist. I explained that was a peridontist and the other was my dentist check up and she said it didn't matter - you can only have one evaluation in 6 months. I asked if I could do anything since this sounded absurd. She gave me a fax # to file a grieviance. Has anyone done this? Do I stand a chance? What should I make sure to include? Thanks!
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Go talk to the person at your dentist office who does the billing. Is there another code that could be applied to this visit? If so, can the change it and re-submit the bill?
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