Frenectomy....dental or medical procedure?

[Mskanga]

My daughter's is medically necessary and the insurance company is denying to cover it because it's a dental procedure and they don't cover. Then the dental insurance says it's a medical procedure and they don't cover it. Can I scream ??? Arghhhhhhhh

 

[mrsmom]

The dr that said it was medically necessary needs to write a letter to your insurance explaining it, fight it!! I have a daughter who was born with a cleft palete and i have to fight between all her dental and medical But i aways win. Because if it's mediaclly necessary they have to cover it.
Kim

 

[Snowysmom]

My DH had it done a few years ago and it was treated as a dental procedure. He saw an oral surgeon and our dental insurance paid their portion. He was referred by his orthodontist. Definately get your doctor to detail why it is medically necessary and fight the denial. In children it may become a medical procedure if they need to have it done in a hospital under anesthesia, similar to having wisdom teeth out in a hospital. DH just had local anesthesia in the oral surgeon's office. Good luck with your fight!

 

[6_Time_Momma]

When my DD had it done, insurance covered it without problem. Now, we have a new insurance and they refused to cover DS. Selena and DEstiny still need it done, so I have to talk to the dentist and insurance company to find out why it was denied. I suspect insurance co #2 considers it a cosmetic procedure rather than medical.

 

[Mskanga]

They finally asked for a letter from the dentist explaining why is it medically necessary, the dentist has no problem typing that up, so we should know within a few days if they will pay or not, but the funny thing is that my medical insurance has paid for the consultation of the oral surgeon and guess what?? My dental insurance is not thorugh them. Why would they pay an oral surgeon? Beats me!

 

[disneygals]

My dd 11 had it done when she was 10. It was covered by dental. I had to pay $100 for the anesthesia as it wasn't covered. My other 2 need it, too. This seems to be the hot new procedure. They inherited this frenum thing from their dad, he's never had any problem relating to a "low" frenum.

Vivienne