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The Horror of Dental Insurance & Teeth

So the day is rapidly approaching when I will go to the oral surgeon to have my assessment done, I can only hope that we will be able to get to the procedure quickly and efficiently. I drive nearly 30 minutes to his office and go through all the paper work and the x-rays. Eventually, he comes in to have a sit down with me and we go over everything.

He says they can remove the wisdom teeth in two stages or all at once, it really depends on what the insurance says. I am feeling pretty confident because at this point, anything is better than the constant pain and difficulty eating, talking or just about anything else you use your mouth for. The oral surgeon gives me another prescription for antibiotics because he wants me to stay on them until we get the surgery date set.

Later that day, his office calls and they have opening in two weeks so they schedule my surgery for July 13th. Well, I’ve made it this far, what’s another two weeks right? I spend the next two weeks diligently taking the medication, coping with the pain, using the painkillers only when I can’t stand it anymore and really dive into making sure everything is ready for the procedure.

On July 12th the dental surgeon’s office calls me – it turns out my self-employment insurance will only cover about $77 of the procedure – bear in mind that the procedure is $4300 total. So, of course, I call my insurance company and want to know what’s going on.

Assurance of Payment

After several transfers and false starts and bad connections, I finally find someone with a clear enough accent to explain to me what my insurance is doing. It’s not that they won’t pay for the procedure exactly, it’s just that they won’t guarantee payment. Once the oral surgeon does the work, they can submit all the paperwork and then the insurance company can assess if that is covered.

I was appalled. I asked why they couldn’t pre-certify and they stated because they don’t do that. I banged my head against this wall for another hour or so and said a few colorful things that are best left out of print. Eventually I ‘fired’ my insurance company because this was a load of bunk. Essentially, they wouldn’t guarantee payment, though they might actually cover it all after it was done if they DEEMED it necessary. If THEY deemed it necessary. If not, well, too bad for me.

So after much frustration and admittedly fury on my part, I called my oral surgeon back. Here comes brick wall number 2. They will not perform the procedure without guarantee of payment or payment up front. No, I can’t make payments to them and I can’t wait to see what the insurance will cover – if the insurance will cover it, they can always reimburse me.

Well, since I didn’t have $4,300 just sitting there in the Woman’s Intuition jar on my desk, I was suddenly faced with the idea that I was in agony, my wisdom teeth were growing in and there was no end in sight.

Now what do I do? Come back tomorrow to find out what happened next.

This entry was posted in Dental and tagged , , , , by Heather Long. Bookmark the permalink.

About Heather Long

Heather Long is 35 years old and currently lives in Wylie, Texas. She has been a freelance writer for six years. Her husband and she met while working together at America Online over ten years ago. They have a beautiful daughter who just turned five years old. She is learning to read and preparing for kindergarten in the fall. An author of more than 300 articles and 500+ web copy pieces, Heather has also written three books as a ghostwriter. Empty Canoe Publishing accepted a novel of her own. A former horse breeder, Heather used to get most of her exercise outside. In late 2004, early 2005 Heather started studying fitness full time in order to get herself back into shape. Heather worked with a personal trainer for six months and works out regularly. She enjoys shaking up her routine and checking out new exercises. Her current favorites are the treadmill (she walks up to 90 minutes daily) and doing yoga for stretching. She also performs strength training two to three times a week. Her goals include performing in a marathon such as the Walk for Breast Cancer Awareness or Team in Training for Lymphoma research. She enjoys sharing her knowledge and experience through the fitness and marriage blogs.