Is this a Fraudulent Case?b
I’m trying to understand if this is normal or if something is off.
I had 5 teeth removed and they gave me a temporary bridge. I paid $4,500 upfront.
But when I got the ADA claim form they sent to insurance, it only shows $1,810 worth of procedures (exam, X‑rays, and extractions). No bridge, no crowns, nothing else.
The ledger they gave me, however, lists a bunch of extra procedures that aren’t on the claim at all, like periodontal scaling, pontics, retainer crowns, and other codes that don’t match what I had done.
They made my husband and I apply for Cherry kind of like Care Credit to pay up front and they’re an in network provider so I feel I was overcharged and they’ll only honor the ADA claim?
I had very bad dental anxiety and finally overcame my fear and this is what I’m dealing with now.
My insurance is from IBEW and this is from their site
DENTAL BENEFITS
Benefits are for the Calendar Year-January 1, 2026-December 31, 2026
MEMBER, SPOUSE, DEPENDENT AGE 19 AND OLDER $1500.00 MAX DEPENDENT CHILDREN THROUGH AGE 18-NO MAX NO DEDUCTIBLE/WAITING PERIOD/MISSING TOOTH CLAUSE PAYABLE ON PREP DATE DENTAL CLAIMS IN COMBINATION WITH MEDICAL PROCEDURES MUST BE SUBMITTED TO THE FUND OFFICE PREVENTATIVE: 90% OF U&C OR GUARDIAN FEE SCHEDULE
ROUTINE ORAL EXAM, PROPHYLAXIS, FLUORIDE; NO AGE LIMIT (ALL PAID TWICE YEARLY); SPACE MAINTAINERS (18 & YOUNGER)
BASIC: 85% OF U&C OR GUARDIAN FEE SCHEDULE
RESTORATIVES, EXTRACTIONS, PERIODONTICS, ALL 4 QUADS MAY BE DONE AT THE SAME TIME; ENDODONTICS (WE DO NOT DOWN GRADE); CROWNS,
BITEWING X-RAYS (TWICE YEARLY); FULL MOUTH X-RAY (EVERY 36 MONTHS); SEALANTS (13 & UNDER)
MAJOR: 50% OF U&C OR GUARDIAN FEE SCHEDULE
BRIDGES, PARTIALS, DENTURES (REPLACEMENT EVERY 5 YEARS), AND IMPLANTS
ORTHODONTIC BENEFITS
NO DEDUCTIBLE NO AGE LIMIT $2000.00 MAX 50% AUTO MONTHLY
CLAIMS MAY BE SUBMITTED BY FAX OR MAIL TO:
NECA-IBEW WELFARE TRUST FUND
2120 HUBBARD AVENUE
DECATUR, IL 62526-2871 FAX: 217-875-1487
WE DO NOT ACCEPT ELECTRONIC CLAIMS AT THIS TIME