Dental Insurance/Bill question - Page 9

Puppy Lips · ‎05-09-2010

@Carmie wrote:
@Puppy Lips wrote:
@AuntMame wrote:
@Puppy Lips wrote:
@reiki604 wrote:
This thread saddens me. I see a parent teaching her children that responsibility for oneself is not important and that rules, regulations and restrictions are for other people. What the OP is teaching by example is entitlement. Now we can see how it starts. I hope the OP never complains about the sense of entitlement others have.
@reiki604Oh please, my son is 20, and was on a break between college and a summer internship. He is on our dental plan and is not even aware any of this is going on. This is not "entitlement" because we pay for the dental insurance.

Since he is 20 maybe it's time that mom be relieved of dental care duty and the college junior be encouraged to make his own dental appointments as well as make sure that the dentists get paid?
My son is on a family dental plan that takes kids until they are 30 years old. He is 4 hours away at college and does NOT have a car. I am not going to ask him to find a local dentist that takes our insurance, make an appointment that fits in with his 18 hours of classes, an on campus job, and tons of homework, have him hire an uber car to get there, and another uber car to take him back to his appartment. If you want to put that responsibility on your kids, then so be it. But I am not going to put that responsibilty on him in his currrent situation.
Your dental policy allows children/adults up to age 30 cost $94 a month and you cancelled it?!!!

Yeah right! Something is not right here. Me thinks you better go back and read your policy again. If what you said is correct,why in blue blazes would you cancel the golden dental family plan of the century?

Yes, we paid $94 a month for 4 people. I think it may be a state of Florida thing that they stay until until they are 30 years old, not sure about that though. If all we did was 2 cleanings a year for 4 people, and paid the full amount to the dentist, not the reduced amount that the dentist collects from the insurance company, then we would pay slightly over the $1128 yearly premium on our own. So really it is a wash as far as that goes.

I will find other insurance.

Always remember that you are absolutely unique. Just like everyone else. Margaret Mead

Nugbucker · ‎08-07-2018

@Reiki604Well if YOU had read my post, you will know that my son does not even know anything about this dispute. He is back at school, and had we not taken the appointment that we did, he would have gone a year without a dental cleaning. We appealed the denial. Why do they even have an appeal process at all if no decisions can be reversed? You think it is asking for special treatment to use the appeal process? It is not like we were trying to scam the insurance company and get in even more dental cleanings. We were just asking for common sense on the part of the insurance company, which appears to be lacking in this situation. My boys do NOT have a sense of entitlement. I do NOT need definitions from you and I will not discuss this further with you.

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@Puppy Lips- regarding the appeal process, I agree with you. I've appealed several claims for various reasons for patients over the years and they don't bend. And what's really awful for patients is when the insurance reps give us WRONG info. Happens ALL.THE.TIME. I'll appeal, I'll say in my letter to the insurance company to go back and listen to the call, listen to YOUR REP giving me wrong info.. It never matters to them. So what's the point in telling us to do it?! It's maddening. And appealing isn't asking for special treatment. As I said, I've done it many times for patients. Not a big deal.

I'm glad you got this all resolved. And maybe I'll get raked over the coals a bit for this, but- I'm sorry that some of the responses aren't nice towards you. You asked a question, and I'm sure you were angry (who wouldn't be) when you asked if you should pay- pretty normal reaction in my opinion. I have patients in my office in their late teens/early 20's still on their parents' insurances, parents pay the bills... normal. Totally normal, especially when their kids are in college.

As you said in another post- done and moving on, right?

Hope you have a good weekend, @Puppy Lips. Take care.

Puppy Lips · ‎05-09-2010

@Nugbucker wrote:
@Reiki604Well if YOU had read my post, you will know that my son does not even know anything about this dispute. He is back at school, and had we not taken the appointment that we did, he would have gone a year without a dental cleaning. We appealed the denial. Why do they even have an appeal process at all if no decisions can be reversed? You think it is asking for special treatment to use the appeal process? It is not like we were trying to scam the insurance company and get in even more dental cleanings. We were just asking for common sense on the part of the insurance company, which appears to be lacking in this situation. My boys do NOT have a sense of entitlement. I do NOT need definitions from you and I will not discuss this further with you.
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@Puppy Lips- regarding the appeal process, I agree with you. I've appealed several claims for various reasons for patients over the years and they don't bend. And what's really awful for patients is when the insurance reps give us WRONG info. Happens ALL.THE.TIME. I'll appeal, I'll say in my letter to the insurance company to go back and listen to the call, listen to YOUR REP giving me wrong info.. It never matters to them. So what's the point in telling us to do it?! It's maddening. And appealing isn't asking for special treatment. As I said, I've done it many times for patients. Not a big deal.
I'm glad you got this all resolved. And maybe I'll get raked over the coals a bit for this, but- I'm sorry that some of the responses aren't nice towards you. You asked a question, and I'm sure you were angry (who wouldn't be) when you asked if you should pay- pretty normal reaction in my opinion. I have patients in my office in their late teens/early 20's still on their parents' insurances, parents pay the bills... normal. Totally normal, especially when their kids are in college.
As you said in another post- done and moving on, right?
Hope you have a good weekend, @Puppy Lips. Take care.

@Nugbucker Thank you JLO77. I appreciate your comments very much. Some of the responses toward me were a bit over the top in my opinion, and that bothered me. That was my first bad experience with an insurance company, and yea I was mad. But live and learn. Since you were kind enough to post and put it all in perspective, I will leave it at that and not look at this thread again. I prefer to leave on a positive note (yours) and not be subjected to anything else. I hope you have a good weekend as well. Thank you again.

Always remember that you are absolutely unique. Just like everyone else. Margaret Mead

Carmie · ‎10-25-2010

@Nugbucker wrote:

@Puppy Lips- regarding the appeal process, I agree with you. I've appealed several claims for various reasons for patients over the years and they don't bend. And what's really awful for patients is when the insurance reps give us WRONG info. Happens ALL.THE.TIME. I'll appeal, I'll say in my letter to the insurance company to go back and listen to the call, listen to YOUR REP giving me wrong info.. It never matters to them. So what's the point in telling us to do it?! It's maddening. And appealing isn't asking for special treatment. As I said, I've done it many times for patients. Not a big deal.
I'm glad you got this all resolved. And maybe I'll get raked over the coals a bit for this, but- I'm sorry that some of the responses aren't nice towards you. You asked a question, and I'm sure you were angry (who wouldn't be) when you asked if you should pay- pretty normal reaction in my opinion. I have patients in my office in their late teens/early 20's still on their parents' insurances, parents pay the bills... normal. Totally normal, especially when their kids are in college.
As you said in another post- done and moving on, right?
Hope you have a good weekend, @Puppy Lips. Take care.

Of course it is normal for children up to age 26 to stay on their parents insurance coverage, even if they are married. They do not have to be students.

It is the law.

I forgot to add that a provider cannot appeal for a patient unless the denial caused the provider to have to " eat the bill". Example: you can appeal if you are in network and the claim denied because you did not submit the claim in a timely fashion. Or, the claim denied as not medically necessary.

You cannot appeal if the claim denies as coverage cancelled or the service is not covered or some other reason where the patient is responsible for the bill when the claim denies, such as the case with the OP.

if your office is not required to write off the expenses and you are allowed bill the patient, you can't appeal for them. That's the law too.

You can write the letter, but the insurance company needs the patients signature on the letter to start the appeal process.