I am allowed to two teeth cleaning per year with no six month interval requirement which the insurance customer service reps confirmed at least on two occasions. However, after getting my 2nd teeth cleaning for the year, they dug out some mysterious "EMBEDDED CLAIM" for some service rendered back in January of this year. They claim that EMBEDDED CLAIM contained another teeth claim so I can't have 3rd teeth cleaning covered. They added that EMBED CLAIMS do not show up online on my insurance account. Had they shown the EMBEDDED CLAIM online I would not have gone for the cleaning, and I seriously have doubts about embedded claim as I never received the EOB. However, the submitted cost for the cleaning is $80. Do I just swallow it and pay because it may not be worth the process of appealing and writing bunch of letters to BBB and making phone calls and keep explaining? There was no mis-communication. The insurance company's customer service reps clearly misinformed me, and they should have listed this embedded claim online under my account. What do you think I should do?
--------------------
I'm not sure what an "embedded claim" is. I work the front desk at a dental office and I'm confused about what you told me. What I suggest you do is pay the bill for your dentist (it isn't their fault that your ins didn't pay.) Also, you could ask the front desk to help you send an appeal to your ins company. They have experiences and resources you don't. It's part of their job to help you with ins. Also, once you pay your bill, they will be more inclined to help you and your ins can reimburse you or the dental office if they end up paying for your cleaning. Good luck!
Source
No comments:
Post a Comment