Wisdom teeth out. told dentist would take care of insur. bill sent 2med ins not dental claim denied. what 2 do

Question

I was told by the oral surgen office that they would decifer who would pay for more coverage dental or medical insurance. Come to find out they went with my medical insurance. They told me that my balance was $410, and insurance would pay the rest. I paid that. Then I get a bill saying that the claim was denied due to not being refered by my primary care physcian, and I owe the remainder of the balance: $2400.00. What are my options. I was refered by my delta dental dentist, do I demand that they chase them down. I am not paying this. My teeth were not hurting, but though that it would be a good preventitive measure.

Answer 1

have the oral surgeons office file the claim with delta. if they were going to submit to your medical, they would have been responsible to get a referral from your pcp. if they won't submit to delta call delta and explain the situation to them. i think they filed incorrectly. i work in a dental office doing the ins. I would NEVER file a claim with someones medical. good luck

Answer 2

First: why does everybody want to sue everybody? For crying out loud, you got the work done, you owe the money.

Second: advice about talking to Delta is a great idea. You pay them (or your emplyer does) so they will do their best to help you.

Third: Oh, yes, I very much CAN send an account to collection if they offer $5 per month on a $2400 balance. I just refuse to accept that arrangement and off they go.

Fourth: Your oral surgeon wants to get paid and they know you probably don't have the money. They are very motivated to assist you to file the claim to your dental carrier. Call your referring dentist, too. They are the ones who sent you to the oral surgeon and it reflects on them that things went badly.

Last: Try not to become an enemy of the oral surgeon's office, your primary dentist, or the insurance companies. You'll get farther if you sincerely and politely ask for help. Everyone wants the same thing here - to get paid!

Answer 3

I agree with one hot mama, I am a dental assistant and we never file with medical insurance. I do know that Oral Surgeon offices are different though. Delta is kinda a tricky insurance company.. It may not be your dentists fault though. As a dental assistant I will say though that you did get the services done and the office deserves to be paid in full for the work. It is your responsibility to ensure they get full payment, so if this means you go out of your way to deal with the insurance company, then you need to do this. They probably see over 100 patients a month and take numerous insurances, so you can not expect them to know every detail of your policy. Also, my gosh, how many teeth did you get taken out??? $2810.00??? Our office charges $450.00 for a complicated wisdom tooth.

Answer 4

Go back to the dentist and have them resubmit to your dental insurance. If it get denied again, sue the dental office for incompentcy. Not the dentist. The person who filed the claim.

Answer 5

Sometimes it is filed with medical because alot of med. ins. will pay for it so that you don't have sinus problems later and have to have surgery for that. If they determined it would be best to file medical they should have a pre-treatment estimate or some sort of pre-certification from either or both companies.

Answer 6

write to them tell them you would like a second option or ring them

Answer 7

sue the world

Answer 8

5 BUCKS A MONTH. THAT WAY THEY WON'T TURN YOU OVER TO A COLLECTION AGENCY.

Answer 9

PAYMENT PLAN