02/27/2024
๐๐๐ฅ๐ฎ๐ & ๐๐ฉ๐ฉ๐ซ๐๐๐ข๐๐ญ๐ข๐จ๐ง ๐๐จ๐ซ ๐จ๐ซ๐๐ฅ ๐ก๐๐๐ฅ๐ญ๐ก ๐๐ง๐ ๐๐๐ง๐ญ๐ข๐ฌ๐ญ๐ซ๐ฒ ๐ก๐๐ฌ ๐๐๐๐ข๐ง๐ข๐ญ๐๐ฅ๐ฒ ๐ ๐จ๐ง๐ ๐๐จ๐ฐ๐ง๐ก๐ข๐ฅ๐ฅ ๐ข๐ง ๐ซ๐๐๐๐ง๐ญ ๐ฒ๐๐๐ซ๐ฌ.
Patient: Why didnโt insurance cover x procedure? They deemed it not necessary after it was done and submitted.
Me: Of course itโs easy for someone from an insurance company to deem something not necessary without being clinically present to review and diagnose your needs in person. Having Insurance coverage does not guarantee that your treatment needs will be covered without interference and or dictations.
๐ผ๐๐ ๐ข๐๐๐๐๐ ๐๐๐๐๐๐๐๐๐ ๐๐๐๐๐๐ก๐ ๐๐ ๐ ๐๐ข๐ ๐๐๐๐ ๐ . ๐โ๐๐๐ ๐๐๐๐ ๐๐๐๐ ๐๐ ๐ก๐ ๐๐๐๐ฃ๐๐๐ ๐ฃ๐๐๐ฆ ๐๐๐ก๐ก๐๐ ๐๐๐ฃ๐๐๐๐๐ ๐คโ๐๐๐ ๐๐๐๐๐๐๐ก๐๐๐ โ๐๐โ ๐๐๐๐๐๐ข๐๐ .
They don't know your risk factors, dental history, and/or contribute to maintaining your oral health. They will deny or dictate what should be covered and after many appeals and โbusy work,โ they ๐ฆ๐ข๐ ๐ก๐ญ re-consider.
It takes MONTHS to appeal on behalf of patients.
(Patients are unaware that this is done as a courtesy)
We wouldn't accept an insurance adjuster denying a car or home insurance claim without coming out to look and inspect your property; so why would it be any different by trusting and accepting an insurance denial via paper and question a trained dental professional for making a proper diagnosis on what is needed based on clinical findings that has been discussed in detail and accepted in person.
๐๐ฎ๐๐ฅ๐ข๐ญ๐ฒ ๐ฉ๐ซ๐จ๐ฏ๐ข๐๐๐ซ๐ฌ ๐ญ๐๐ค๐ ๐ ๐๐ข๐ ๐ฅ๐จ๐ฌ๐ฌ ๐๐ซ๐จ๐ฆ ๐ข๐ง ๐ง๐๐ญ๐ฐ๐จ๐ซ๐ค ๐ข๐ง๐ฌ๐ฎ๐ซ๐๐ง๐๐ ๐๐จ๐ฆ๐ฉ๐๐ง๐ข๐๐ฌ ๐๐ ๐ญ๐ก๐ ๐ซ๐๐ข๐ฆ๐๐ฎ๐ซ๐ฌ๐๐ฆ๐๐ง๐ญ๐ฌ ๐๐ซ๐ ๐ฅ๐ข๐ญ๐ญ๐ฅ๐ ๐ญ๐จ ๐ง๐จ๐ง๐; ๐ฎ๐ฌ๐ข๐ง๐ ๐ช๐ฎ๐๐ฅ๐ข๐ญ๐ฒ ๐ฅ๐๐๐ฌ ๐๐จ๐ซ ๐๐ซ๐จ๐ฐ๐ง๐ฌ ๐๐ง๐ ๐ข๐ฆ๐ฉ๐ฅ๐๐ง๐ญ๐ฌ ๐ญ๐ก๐๐ญ ๐ฐ๐ข๐ฅ๐ฅ ๐ฅ๐๐ฌ๐ญ ๐ฆ๐๐ง๐ฒ ๐ฒ๐๐๐ซ๐ฌ ๐ญ๐จ ๐๐จ๐ฆ๐ ๐๐ซ๐ ๐๐ง ๐ข๐ง๐ฏ๐๐ฌ๐ญ๐ฆ๐๐ง๐ญ ๐ญ๐ก๐๐ญ ๐๐๐ง๐๐๐ข๐ญ๐ฌ ๐ง๐จ ๐จ๐ง๐ ๐จ๐ญ๐ก๐๐ซ ๐ญ๐ก๐๐ง ๐๐๐ ๐ฉ๐๐ญ๐ข๐๐ง๐ญ๐ฌ...
Please do your research and ask questions. Advocate for your dental health and protect the trusted relationship that you have with your health care providers.
Ask for the best care you deserve. Don't allow insurance companies to dictate your needs or what they feel is an โacceptable alternate benefitโ
You deserve longterm oral health stability, please donโt ask your doctors to change their quality treatment standards to โfitโ what is covered or allowed by insurance companies.๐ฆท
