Medical vs dental insurance all failing me for biopsy
Help me. Oral surgeons don’t want to take medical insurance. No other provider will perform biopsy.
I’m stuck in a crazy loop here. I’ve called 20 different oral surgeons.
They say “we don’t bill medical insurance” we only bill dental insurance. A biopsy is not dental, it’s medical.
I need a biopsy and ct scan of my gums. There is something in there per my dentist.
The medial has no in network providers that do this. I called their in network providers. They don’t perform biopsies.
So now I need a deficiency for out of network providers to be treated as in network. Fine.
None of the oral surgeons want to submit a pre authorization without me coming in and doing a consult ($200) along with a ct scan ($400). Only after will they even attempt to write a letter for pre authorization. But as I said before they won’t bill insurance. It’s their tricky way to telling me I pay everything out of pocket to them. Then if and when insurance chooses to pay anything , I get to keeep it. Even if it’s Pennies on the dollar.
The oral surgeons are trying to use fancy works for “we don’t bill medical but can give you the paperwork to do it “. You get what you get from insurance. As you know contracted rates are sometimes 80% off.
The oral surgeons are not forthcoming and want what they want. They refuse to bill medical direct and want money upfront t from me.
They refuse to even engage my medial until after my $600 has been paid upfront for a consult and ct. which cannot be retroactively billed
You also cannot get a retroactive pre authorization for services already rendered.
I’ve spent 20 hours on this so far.
Not to mention pathology which is out of network as well and I have to pay cash for.
What should I do here. ??