Dental Insurance Question

[cabanafrau]

My experience is different.

I am caught in a situation now where I had a ceramic crown put in, and my dental insurance, as of January 1st, only pays for metal crowns. The business manager didn't know until my claim was rejected. The ceramic crown I had put in 3 weeks earlier, in December, they paid for. Go figure.

Is this the different experience you are referring to? If so it's hardly comparing apples to apples.

I actually do know how my dentist's practice handles this type of situation as our insurance provider has made coverage changes over the year regarding things like fillings, x-rays, sealants, etc. The practice admin verifies every procedure before the appt. In your case the business manager didn't bother to check the update for the new year before your appt. Our dentist would have made it right and not asked us to pay the overage.

 

[_19disnA]

I would find a new dentist. It makes NO sense the dentist continued to provide dental services knowing the insurance coverage couldn't be used. Every doctor/dentist/etc. I have ever been to confirms your coverage before doing any type of visit. I could see that the insurance company might have told the dentist they could not tell their patients WHY the coverage was dropped (i.e. some sort of dispute, payments or billing issues.....etc.)...........that makes sense to me. For the dentist to continue to provide billable services knowing your insurance was no longer applicable seems very shady to me.

 

[LuvOrlando]

Wow, this sounds like a nightmare, that's a lot of money for a thing you could probably manage better in network.
I'd completely blame my dentist's office for not at least steering me to talk to insurance without explanation- nudge nudge wink wink. It's one thing to not divulge a secret, it's quite another to knowingly rack up my bills willfully.



People just rot, I get more jaded by the day so I should be chasing people off the lawn any day now

 

[tvguy]

Is this the different experience you are referring to? If so it's hardly comparing apples to apples.

I actually do know how my dentist's practice handles this type of situation as our insurance provider has made coverage changes over the year regarding things like fillings, x-rays, sealants, etc. The practice admin verifies every procedure before the appt. In your case the business manager didn't bother to check the update for the new year before your appt. Our dentist would have made it right and not asked us to pay the overage.

No it isn't . No disclosures that continue past a contract date are not uncommon.

 

[Allison]

Lots of non-disclosure clauses make no sense, but they happen.

Not in this situation. It just isn't a thing. Non-disclosure around coverage, nope, not a thing.

 

[tvguy]

Not in this situation. It just isn't a thing. Non-disclosure around coverage, nope, not a thing.

Sorry, my neighbor works for Delta Dental and it IS a thing, in some cases, with them. Although your question would be best directed at the OP.

 

[Kimkimba]

Our dentist always gives us a breakdown of what we’ll owe before the procedure.