Question about dental insurance

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doon
Posts: 119
Joined: Tue May 27, 2014 9:25 am

Question about dental insurance

Post by doon » Thu Jul 11, 2019 9:45 am

My dependent is getting a multi year procedure done that started in 2018 and continues on in 2019. My company changed insurances from Metlife(2018) to Guardian(2019).
For some of the procedures that were performed in end of 2018 but billed in early 2019, Guardian is refusing to pay for those as they were not the providers in 2018.

I am stuck in between as the dental office wants the money for those services.

Can I go to Metlife and ask them to pay for it? Or am I the left who will have to eat this up?

Thanks in advance!
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rantk81
Posts: 231
Joined: Tue Apr 18, 2017 8:12 am

Re: Question about dental insurance

Post by rantk81 » Thu Jul 11, 2019 9:48 am

What do you mean "billed in 2019"?

The bills should have a procedure date on them for each service, and the insurance that was in effect at the time (the old one) should be the one paying the claims.

jebmke
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Joined: Thu Apr 05, 2007 2:44 pm

Re: Question about dental insurance

Post by jebmke » Thu Jul 11, 2019 9:51 am

In my experience, the bill should be processed based on the procedure date (2018). Insurance companies normally reserve for run-off claims that are submitted after the end of the contract but representing liabilities incurred as of the end date.
When you discover that you are riding a dead horse, the best strategy is to dismount.

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HueyLD
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Joined: Mon Jan 14, 2008 10:30 am

Re: Question about dental insurance

Post by HueyLD » Thu Jul 11, 2019 9:57 am

doon wrote:
Thu Jul 11, 2019 9:45 am
My dependent is getting a multi year procedure done that started in 2018 and continues on in 2019. My company changed insurances from Metlife(2018) to Guardian(2019).
For some of the procedures that were performed in end of 2018 but billed in early 2019, Guardian is refusing to pay for those as they were not the providers in 2018.

I am stuck in between as the dental office wants the money for those services.

Can I go to Metlife and ask them to pay for it? Or am I the left who will have to eat this up?

Thanks in advance!
Your dentist office screwed up. They should have filed with MetLife. Call and ask them to resubmit the claim with ML.

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Stinky
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Location: Sweet Home Alabama

Re: Question about dental insurance

Post by Stinky » Thu Jul 11, 2019 10:17 am

Your dentist may be very competent. But the dentist's office staff (or at least one person on the staff) is incompetent, especially if you've brought this to their attention before.

Tell them to file with the company who provided the insurance at the time that the procedure was performed - in your case, Metlife.
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