Dentist Used Non Credentialed Provider – Recourse?

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I selected a pediatric dentist for children based on in-network coverage with company insurance some time ago. No issues on the first visit, billed as expected and covered as our deductible was met. On 2 subsequent visits, the dentist apparently used providers that were not in-network and insurance denied the claims as such.

When communicating with billing for the dentist, they stated that the providers were pending credentialing with insurance, and would re-file. 2 further inquiries were not responded to. Covid came along and we got sidetracked. Did not receive any communication since date of service, until a few weeks ago when we got a bill with the original charges, over a year after initial date of service.

What recourse do I have here? I’ve always been very careful with verifying coverage with medical visits, unfortunately here there was no indication these providers would not be covered.

submitted by /u/AncientIce2531
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I selected a pediatric dentist for children based on in-network coverage with company insurance some time ago. No issues on the first visit, billed as expected and covered as our deductible was met. On 2 subsequent visits, the dentist apparently used providers that were not in-network and insurance denied the claims as such. When communicating with billing for the dentist, they stated that the providers were pending credentialing with insurance, and would re-file. 2 further inquiries were not responded to. Covid came along and we got sidetracked. Did not receive any communication since date of service, until a few weeks ago when we got a bill with the original charges, over a year after initial date of service. What recourse do I have here? I’ve always been very careful with verifying coverage with medical visits, unfortunately here there was no indication these providers would not be covered.
submitted by /u/AncientIce2531 [link] [comments]Read Morer/HealthInsurance

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