Medical Insurance will not cover Dental Procedure for autistic son?!
Question: Medical Insurance will not cover Dental Procedure for autistic son!?
I have a 7 year old autistic son!. He had a cavity and the dentist could not get into his mouth!. So she told us to have it pulled!. Of course he wouldn't let them in his mouth!. They said my insurance would cover the cost of him being put to sleep, they would pull the tooth, do a cleaning, and put on sealant!. Now I am receiving bills for this!. The dentist put it in as a dental procedure not covered under my dental plan!. So i had them put it in as a medical and still nothing!.
Can someone help me!? It was not cheap!. I pay a lot of money for insurance and not to get coverage is killing me!
Please help!.
Thank you,
JessicaWww@Answer-Health@Com
Can someone help me!? It was not cheap!. I pay a lot of money for insurance and not to get coverage is killing me!
Please help!.
Thank you,
JessicaWww@Answer-Health@Com
Answers:
You should have recieved an EOB (explantion of benefits) explaining what was payed for!. If the doctors office submitted the claim with the wrong procedure code then his office is in error!. You need to call your dentist tell them that they entered the code in wrong and have them resubmit the claim with the correct procedure code!. If they do not fix the problem kindly ask them for a copy of his Treatment plan and a copy of all the work that was completed on your child, then you call your insurance and dispute it, you will have the proof of what was really done!. You stated that they said the insurance will cover the cost of him being put to sleep, but did it cover the cost of the extraction as well!? You have to make sure you didnt max out on your insurance, if it was maxed then the remaining balance is your responsibility!. Www@Answer-Health@Com
Wow, the insurance game!. Insurance companies I hate them!. They constantly llok for loop holes to deny legitimate procedures!. anyway that my 2 cents!. What you need to do is contact the dental association in your state and asked if there are clinic s that work with special needs patients!. Many of the special needs patients are uninsured or habve insurance that sucks, but bc many are non profit they will see the child, also on occasions these clinics get grants to use in cases like yours!. Www@Answer-Health@Com
I wish I knew the answer to your question!.!.!.!. insurance sucks!. I would call that dental office and make their insurance person straighten it out!.
I would recommend that you take your son to a pediatric dentist from now on!. They are trained to help children and even adults with special needs!. I'm sure their billing would also work out much better!.
Best of luck!
Www@Answer-Health@Com
I would recommend that you take your son to a pediatric dentist from now on!. They are trained to help children and even adults with special needs!. I'm sure their billing would also work out much better!.
Best of luck!
Www@Answer-Health@Com