NOT SURE if posting in the right place!
BACKSTORY:
First time I went to this dentist was about 2 years ago for my first cleaning under my insurance at the time (Kaiser). After my first cleaning they said I needed a deep clean. I decided to wait. Once Covid hit I lost my job and with it my insurance. I’m now employed again and have new dental insurance. It’s been about a year and a half or 2 years almost since my last cleaning, so I made an appointment 2 weeks ago for today.
NOW…
So my dentists office called me about an hour ago to tell me that they reviewed my file and saw that I needed a deep cleaning. They asked if ever got it done and I told them no. They then told me that they couldn’t do the regular cleaning because “your insurance won’t pay for it”. I was confused because why wouldn’t a dental insurance plan not pay for a regular cleaning; that’s the whole point of having insurance.
I told them I’d call them back to reschedule my appointment with them. I then called my insurance company and spoke with someone who told me I am covered for TWO cleanings per year. They advised me to make sure I provided the correct insurance info and to tell my dentists office they can call my insurance directly to confirm coverage.
I called my dentists office back and told them I spoke to my insurance and that they said they would pay the claim for a regular cleaning. The dentist office manager then asked to put me on hold while she speaks to her “insurance coordinator”. After a few minutes she came back on the phone and said “I was just told we can’t do a cleaning because that’s unethical. Like, we would be unethical to do that when what you need is the deep cleaning”.
I told her “ok, I get that, and I’m not trying to avoid that, but that’s different than saying my insurance won’t cover a regular cleaning”.
She literally said, “yeah I just misspoke”.
What’s going on here? Something seems off about how this office runs? I made my appointment 2 weeks ago, and no one reviewed my file to tell me ahead of time that I need to schedule a deep clean not regular clean? They call me an hour before my appointment to tell me all this?
How would my new insurance know that my dentist recommended a deep cleaning (2 years ago, when I had an entirely other insurance company) and therefore use this as a reason to deny a regular cleaning claim?
I am scheduling my deep cleaning at another dentist. This entire thing seems shady as hell. Does this sound like a scam or fraud to get more money from my insurance or is just just a very poorly managed dentist office?
submitted by /u/JzxGamer
[link] [comments]
NOT SURE if posting in the right place! BACKSTORY: First time I went to this dentist was about 2 years ago for my first cleaning under my insurance at the time (Kaiser). After my first cleaning they said I needed a deep clean. I decided to wait. Once Covid hit I lost my job and with it my insurance. I’m now employed again and have new dental insurance. It’s been about a year and a half or 2 years almost since my last cleaning, so I made an appointment 2 weeks ago for today. NOW… So my dentists office called me about an hour ago to tell me that they reviewed my file and saw that I needed a deep cleaning. They asked if ever got it done and I told them no. They then told me that they couldn’t do the regular cleaning because “your insurance won’t pay for it”. I was confused because why wouldn’t a dental insurance plan not pay for a regular cleaning; that’s the whole point of having insurance. I told them I’d call them back to reschedule my appointment with them. I then called my insurance company and spoke with someone who told me I am covered for TWO cleanings per year. They advised me to make sure I provided the correct insurance info and to tell my dentists office they can call my insurance directly to confirm coverage. I called my dentists office back and told them I spoke to my insurance and that they said they would pay the claim for a regular cleaning. The dentist office manager then asked to put me on hold while she speaks to her “insurance coordinator”. After a few minutes she came back on the phone and said “I was just told we can’t do a cleaning because that’s unethical. Like, we would be unethical to do that when what you need is the deep cleaning”. I told her “ok, I get that, and I’m not trying to avoid that, but that’s different than saying my insurance won’t cover a regular cleaning”. She literally said, “yeah I just misspoke”. What’s going on here? Something seems off about how this office runs? I made my appointment 2 weeks ago, and no one reviewed my file to tell me ahead of time that I need to schedule a deep clean not regular clean? They call me an hour before my appointment to tell me all this? How would my new insurance know that my dentist recommended a deep cleaning (2 years ago, when I had an entirely other insurance company) and therefore use this as a reason to deny a regular cleaning claim? I am scheduling my deep cleaning at another dentist. This entire thing seems shady as hell. Does this sound like a scam or fraud to get more money from my insurance or is just just a very poorly managed dentist office?
submitted by /u/JzxGamer [link] [comments]Read Morer/HealthInsurance