Question about my insurance declining to pay for a crown and leaving me with a sizable balance

So I’ve been going back and forth with my dentist because out of nowhere they told me I have a $2200 balance, and i absolutely cannot get them to understand my question. Here’s what happened:

My yearly max under my plan was $1000. I had like $6000 worth of dental work done that year, so I paid out of pocket for most of it. I was paying as we went along, and after that 1000 I paid for everything. I was being charged the price for the dental work that they would have charged my insurance, because i was insured I was just over my maximum, so the work wasn’t full price that an uninsured person would have paid which I assume is standard.

And then, my insurance ended up declining to pay for the procedure that that 1000 went to for whatever reason. So I figure that’s now what I’ll owe, right? Because if I paid all costs except that 1000, and they declined the 1000, that’s what’s now missing, right?

But I owe 2200 now. Which I guess is full price for the crown. And I don’t understand why, or how it happens that my max is 1000, they decline the 1000 and I owe double. I’m assuming this 2200 is the full, uninsured price for the crown.

I did lose my insurance by the time this was all going on so I’m wondering if when they realized they had to charge me for the crown they saw I was uninsured now and charged me full price? Or is this standard that if your insurance declines a procedure that you pay full price?

I hope I explained this clearly, because I’m really struggling to communicate about this to my dentist. Thanks!

Edit: for clarity, at the time of the procedure I was insured. By the time all the back and forth about my insurance not covering happened I was no longer insured

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u/dmorelli99 — 4 days ago

Finished my first shift. A few questions for seasoned drivers…

The cast characters i met was crazy lol.

  1. I picked up an 88 year old man with a walker from a retirement community. His destination was a grocery store. When he got to the car he told me that he actually needs to go to the liquor store, which is right next door so that’s fine, and told me that his son doesnt let him program in the liquor store as a destination and that there’s a cash tip in it for me if I bring him there AND also then back to the community, which wasn’t a part of the ride. Ethics of helping an alcoholic get liquor aside, I know from reading here that we prefer that riders enter their trip correctly on the app. But I did it, and I left the trip running so it essentially cost him double what the trip cost in the beginning bc we drove further. Then he gave me a 10 dollar tip. Question is, do you think he meant for me to go offline and take his tip as payment? I’d imagine it’s unsafe and frowned upon to take trips offline? Would everyone else have kept the trip running online?

  2. I picked up a woman with a toddler and a baby in a car seat. She claimed to have no use of her left arm so she asked me to load her car seat into my car. I have no children and have never once used a car seat lol so of course I put it in backwards and she sighed at me. Should I get used to having to load peoples children or do we think that’s their responsibility?

These are my big questions thanks for your time.

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u/dmorelli99 — 10 days ago

Counselor nods and slurs her speech during session?

Hi! So the title says it, I have a counselor that nods out and gets slurry during session. I gave her the benefit of the doubt for a while, I know she has some mental health issues and that her manic episodes are incredibly intense and disturbing to her life so I assumed she was on a heavy duty medication, but it’s getting worse so I’m starting to think she’s abusing benzos or something. I don’t think it’s like street drugs, but I guess there’s no use speculating and it doesn’t make a tangible difference.

it makes me dread session. When I can tell she’s slipping I have to stop talking about myself and start throwing in curveball questions to keep her stimulated. It makes it so that I really can’t start any conversations about myself, which sucks. I’m mandated a certain amount of sessions to keep my meds so I can’t stop going.

I know there’s a lot of ethical and practical concerns in this issue, but I’m hoping for a professions take on a realistic way to manage this. Should I say something? It’s so awkward to think about calling out that she’s really not with us and on a different planet. There are higher up’s, but I also hate the idea of filing a complaint. The slurring is so bad sometimes, it’s so uncomfortable. We have group sessions too and we all end up having to lead the group ourselves. She keeps talking about how she’s working on licensure and I’m like yeesh, sometimes I try and encourage her into non clinical work lol.

Anyone have any advice?😕

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u/dmorelli99 — 1 month ago

Pls help! Looks like BV but isn’t?

35F. I’m so confused and need to consult other women. I was so certain I had BV. The smell is strong, my vaginal fluid is very thick, clumpy and opaque off-white. I had an internal and the OB was immediately like oh yea something is going on when she saw the thick discharge, but then we did the tests and I don’t have any infection or yeast. I could have sworn whatever is going on was responsive to antobiotics too, like a month ago I took a course of antibiotics before they actually confirmed whether there was BV and I thought it got better, the smell got better and my fluid thinned out and turned back to clear more often. But then I got a yeast infection, treated that, and then the symptoms came back.

So I feel like I have BV but the tests say I don’t. Maybe I’m just totally clueless as to what a vagina is supposed to smell like and how fluid should be? Does anyone have any thoughts about what might be going on? I’m experimenting now with not using soap when I wash but I’m so discouraged. Thanks!!

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u/dmorelli99 — 2 months ago

Crowns without root canals

I’m wondering how often dentists place crowns without doing root canals, and what makes it more likely to need a root canal with your crown.

Long story short, my teeth were in bad shape. The entire treatment plan involved about 6 extractions, 8 fillings and 6 crowns. The teeth we were crowning were made clear to me that they were in pretty bad shape and were likely to need root canals in the future but that we were just kinda gonna go for it and hope they heal without doing a root canal. I got 6 crowns over about a year, including both molars 18 and 31 that were like very bad.

Fast forward every single one, all 6, within a few months like failed and needed root canals, and I’m pretty devastated that I lost tooth 31 because after the crown was placed the pain was so excruciating that I couldn’t wait for root canal consults, I needed to move for extraction. That site developed a dry s0cket and I still feel nerve pain 6 months later. It was a so horrible. This has cost me a ton of money, pain, several different dentists, and time.

The question is, every dentist I’ve seen after that, whenever they recommend a crown, they recommend a root canal alongside. So I’m just confused why my dentist did 6 crowns on severely degraded teeth without recommending a root canal. I’m just confused and upset I lost teeth I didn’t have to, I have crowns here still in pain that I need RCTs on. If I would have known at the time that root canals are frequently done alongside crowns I would have pushed for it bc I knew how bad the teeth were.

Is this a common way to move forward with teeth that need this treatment? I felt so unlucky that all failed but then I wondered if it was because all probably needed root canals at the time.

Thank you.

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u/dmorelli99 — 2 months ago

F/35, formerly bad oral hygiene, I drink coffee, don’t smoke. I hadn’t had a cleaning in years and I had decay and brown staining along my gum line. I went and got the decay filled, it was along most of my front teeth.

Now, plaque is accumulating like shockingly fast just along where the cavities were filled, and just that area seems to be yellowing shockingly fast too. I mean like I’m brushing twice a day, flossing, but normal brushing isn’t getting off the material that’s now attracted to the fronts of my teeth near the gumline. At the time i took this pic I brushed in the morning but not yet at night.

1- is this real? Does the material used to fill cavities attract plaque easier?

2- can I do anything? Just go for professional cleanings more often? It’s feeling a lot like normal brushing isn’t really taking it off.

Thanks!!

u/dmorelli99 — 2 months ago