A denied dental procedure does
not mean the procedure wasn’t necessary.
It just means your insurance carrier won’t cover it as a benefit of your
plan. Limitations in an employer’s group
policy most likely result in these noncovered procedures. This is a huge problem for your healthcare
provider, because your care provider is trying to do what you need and not what
is paid for by your insurance carrier. To
compound these denials, some policies are designed such that they do not allow
the dentist charge you for certain procedures.
However, that does not mean your dentist can avoid the procedure because
it may be absolutely necessary as a part of your treatment. This scenario has left your dentist wondering
whether or not you will pay for the services being rendered because your
insurance carrier is denying a necessary procedure and lack of patient
understanding. And finally, this
scenario has left your dentist perplexed as to how to overcome the perception
by patients that they are not being honest with them.
The solution is patient ‘push
back’ for the coverage you’re entitled to.
Patients need to question, if not challenge the benefits they have paid
for but have been denied. And patients
need to recognize that the contractual relationship is between you and your
insurance provider, not your dentist and your insurance provider. Your dentist has absolutely not leverage with
your insurance carrier.
Hopefully, this is a little
helpful in understanding the difficulties in receiving your full insurance
benefits. If we can answer any of your
concerns or questions, please feel free to contact us.
Novy Scheinfeld, DDS, PC
290 Carpenter Drive, 200B
Atlanta (Sandy Springs), GA 30328
404-256-3620
Thank you for all your referrals. We truly appreciate them.
Information included is not dental or medical
advice. For your specific information
be sure to
consult your dentist.
Related articles
·
Dentist Sandy Springs: 20 year
Anniversary (therightsmile.wordpress.com
·
Dentist Sandy Springs: Alert - Dental
Insurance Code Bundling (therightsmile.wordpress.com)
No comments:
Post a Comment
We hope you find something useful in our blog. But if not, email us and maybe we can answer your questions.