We had two PA denied during our routine exam 4BW2PA. They have a dentist reviewed the case and deemed the X-rays unnecessary. Has this happened to you before? This is not a lot of money but seems extremely petty.
I’ve never really paid much attention to dental insurance as it was free through my job and I didn’t have a dependent. When I added my spouse it was $15 per paycheck (every two weeks). Now they are increasing it to $34 every 2 weeks. There is a maximum annual benefit of $1,500 per person. However, “cleanings, exams and x-rays” are covered 100%.
If I’m being honest, I haven’t been to the dentist in years and my teeth are in pretty good condition.
Is paying $816 for preventative care that we may or may not use worth it? Of course I’m always worried about those “what if” emergency situations but I haven’t had one since 2020 when I got my wisdom teeth removed. Plus that $1,500 cap makes me think they won’t cover much anyways.. thoughts? I heard cleanings are around $200 without insurance which I could handle.
I apologize for my ignorance on the subject.
I work at a smaller office doing insurance verification and AR, and I've got a stack of Metlife EOBs that need clarification/corrections from an actual human. Does anyone have a trick to get through to a rep?
They make it impossible to get ahold of anyone on the provider's side and it's unbelievable. I've even tried calling as though I was a policy holder and as soon as they find out you're calling from a provider's office they send you right back to the automated system. Any advice is appreciated!