Dental Insurance Denied Coverage on Cleaning (Debridement)

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I had my teeth cleaned by a new dentist back in August in Oregon, and apparently she did a debridement (D3455). At the time, I was not told there was a risk of insurance not paying for it. I didn’t think to ask, because I was just going in for a regular cleaning and who thinks that a cleaning isn’t going to be covered. Insurance denied the debridement, because I had my teeth cleaned back in Feb. They only cover it if no cleaning has been performed in the last 24 months.

Anyway, last week I get a bill from the dentist for $258. When I called, the dentist office was just like, oops we thought it was covered.

Should I appeal this claim and ask my dentist to provide evidence of why the debridement was necessary? What’s the best course of action?

submitted by /u/Cheeseboarder
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I had my teeth cleaned by a new dentist back in August in Oregon, and apparently she did a debridement (D3455). At the time, I was not told there was a risk of insurance not paying for it. I didn’t think to ask, because I was just going in for a regular cleaning and who thinks that a cleaning isn’t going to be covered. Insurance denied the debridement, because I had my teeth cleaned back in Feb. They only cover it if no cleaning has been performed in the last 24 months. Anyway, last week I get a bill from the dentist for $258. When I called, the dentist office was just like, oops we thought it was covered. Should I appeal this claim and ask my dentist to provide evidence of why the debridement was necessary? What’s the best course of action?
submitted by /u/Cheeseboarder [link] [comments]Read Morer/HealthInsurance

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