Maryland (MD).
The ininsurer’s 2021 brochure states that the two codes for billed services have zero copay and no annual limit (so long as two visits per year, and this was wife’s second).
Printed EOB states insurer approved $100 but only paid $30. Although no explanation for this discrepancy is provided, we inferred that the $70 found under “other insurance payment” is related to the underpayment. (My wife has no other dental insurance).
So we went onto the insurer’s website, and the claim summary is a little different here. Still no explanation for the unpaid $70, but “other insurance payment” is $0 here.
It seems like a mistake? Do we have to file an appeal? Seems like something that a phone call might fix. But the dentist wants payment pretty soon – do we need to pay the dentist while the matter is being resolved and hope to later receive a refund?
submitted by /u/Jumaine23
[link] [comments]Maryland (MD). The ininsurer’s 2021 brochure states that the two codes for billed services have zero copay and no annual limit (so long as two visits per year, and this was wife’s second). Printed EOB states insurer approved $100 but only paid $30. Although no explanation for this discrepancy is provided, we inferred that the $70 found under “other insurance payment” is related to the underpayment. (My wife has no other dental insurance). So we went onto the insurer’s website, and the claim summary is a little different here. Still no explanation for the unpaid $70, but “other insurance payment” is $0 here. It seems like a mistake? Do we have to file an appeal? Seems like something that a phone call might fix. But the dentist wants payment pretty soon – do we need to pay the dentist while the matter is being resolved and hope to later receive a refund? submitted by /u/Jumaine23 [link] [comments]Read Morer/HealthInsurance