Comments on: On Dental Insurance, Appeals, and Pulling Teeth

By: anonymous

anonymous — Wed, 10 Sep 2008 20:03:06 +0000

About working with your dentist. Isn’t that the job of the office to A) do the codes correctly and B) fix their own mistakes? I find it rediculous that I’m doing the job of a secretary who is incompentent or doesn’t care.

By: anonymous

anonymous — Wed, 10 Sep 2008 19:59:50 +0000

Welll Cigna is a really bad insurance company my entire familiy has had it for over 4 years and I had to appeal almost every single claim even for a simple examination from a family M.D. Also you have to be absolutely sure of what your insurance will cover. Ask more than once and make sure what you pay out of pocket is definitely covered. Also I was doing some math and I added up how much we had paid in total to the Cigna corporation and subtracted the amount they paid for us. It would have been cheaper if we just paid out of pocket hands down. I would invite that you do the same and see if you are saving any money or just making the board members and CEO of Cigna rich lol

By: Lisa

Lisa — Tue, 27 May 2008 12:32:22 +0000

My husband had some teeth removed. 2 were normal teeth and the other 2 were wisdom teeth. One wisdom tooth was alreay erupted. When the dental office called to see about coverage they said they would pay at 80%. After the procedure they are denying the claim saying they don’t cover wisdom teeth (oral surgery) Our medical only covers if it was boney impacted and it was not. Then who covers this? what a rip off. I am appealing this and first appeal cigna denied it. I am not stopping there. Now the dentist office is trying to bill me for more than what even the insurance was suppose to pay. any advice anyone has please write to me at LetChocolateflow@aol.com

By: Rich Sanfilippo

Rich Sanfilippo — Wed, 14 Mar 2007 18:07:51 +0000

You may want to rethink dental (and vision) insurance. It’s basically a “trading of dollars” deal where neither you nor the insurer make much. Consider putting the premiums into an HSA and use them when you need them.

By: RS

RS — Thu, 02 Mar 2006 20:29:31 +0000

I despise going to the dentists office. I always feel like I am getting taken. I just wrote an article the other day about my experiences there too:
Dental Ripoff?

By: Debbie

Debbie — Mon, 27 Feb 2006 13:12:07 +0000

Wow, it’s not enough you had to suffer the pain of the dental work, then the pain of the insurance company. They will cheat you every time they get a chance.

I worry about all the little old people, who don’t have the fight left in them to go against these companies.

By: Joshua K

Joshua K — Fri, 02 Dec 2005 04:21:54 +0000

Ouchies! I’m needing to get mine done, and I just signed up with Cigna. Coverage begins in January. Does anyone have any tips on making sure that this doesn’t get denied, what I should ask for, etc? Perhaps get confirmation from Cigna that it’s all approved before the operation?

By: nickel

nickel — Sun, 27 Nov 2005 15:01:08 +0000

Yes, they were ’simple’ (i.e., non-surgical) extractions because the teeth had already erupted.

By: Kenny

Kenny — Sun, 27 Nov 2005 06:36:11 +0000

My wife recently had all four of her wisdom teeth cut out and my part (after insurance) was $1182. Did you just have your’s pulled out? I have heard that is significantly cheaper.

By: nickel

nickel — Wed, 23 Nov 2005 12:49:15 +0000

“it might have been easier to have worked more closely with your dentist”

Actually, this was part of the problem… I worked closely with the oral surgeon’s business office on the appeal and ended up getting a huge runaround — This is why it took from the end of April through early July to get a decision on the appeal. The woman in the business office basically lied to me for two months about having submitted the appeal. When I finally called her on it, she claimed that the appeal had been denied. I then contacted Cigna and they said that they hadn’t yet received an appeal, much less denied it. When I finally got the business offive to submit the appeal, Cigna approved it within about 10 days. My suspicion (although I have no evidence of this) is that the oral surgeon tried to give my appeal the good old ‘desk veto’ because, if approved, they would have to accept a lesser amount for the work. In fact, they ultimately had to write off about $400.

By: Flexo

Flexo — Wed, 23 Nov 2005 05:33:19 +0000

My experience seems like a walk in the park compared to yours. I’m still waiting for my refund check, but it’s only been two weeks. I do know how much I’ll be getting and hopefully there will be no surprises…

By: Caitlin

Caitlin — Wed, 23 Nov 2005 00:38:23 +0000

Nickel, I’m glad it worked out for you … sheesh what a nightmare

By: Foster

Foster — Tue, 22 Nov 2005 21:43:58 +0000

…your appeal to CIGNA sounds reasonable, but it might have been easier to have worked more closely with your dentist — to ensure his billing to the insurance company used the correct medical statements & billing codes.

Hasty or indifferent billing ‘paperwork’ by the healthcare provider can negate insurance payments that you are really entitled to…