Not submitting claims

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PostPosted: Tue Feb 16, 2010 9:21 pm   Post subject: Not submitting claims  

Having a weird problem with my new dentist and claims for dental work I've had done by him over the last few months. I've had the same very good medical insurance for many years through my company, and had many doctors/dentists submit claims without issue. This office keeps claiming that they aren't getting any response to the claims they submit. I've verified several times where they should be sending the claims and what number they could call to confirm (and even what number they could fax the claims).
For several months now no claims have been received, but the dentist's office claims that they've sent several times to the address specified on the insurance card. They also claim to have called the number on my card, only there is no record of them calling (just of my calling frequently). Today they say they were told at that number to send the claims to some other local claims address, but I've been assured that no one would have instructed her to do that when calling that number. Apparently they just aren't submitting my claims for some reason and lying about it. I can't determine any reason why they would do this. Can anyone?

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Willet
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PostPosted: Wed Feb 17, 2010 12:08 pm   Post subject:   

Quote:
I can't determine any reason why they would do this.

I won't say that I'm smelling fraud right away!
If your carrier fails to identify this new local claims address as their own, then you might need to get things investigated.
But, have you discussed this issue with your employer?

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anonymous00
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PostPosted: Wed Feb 17, 2010 12:51 pm   Post subject: Not submitting claims  

You simply need to do some investigation here. Check with the contact address of the insurance company yourself. It seems that your insurance carrier is deliberately giving some wrong information.
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PostPosted: Wed Feb 17, 2010 10:23 pm   Post subject:   

Quote:
It seems that your insurance carrier is deliberately giving some wrong information.


Why would you say this. If you read the post, the OP stated that her insurance company has record of her calling multiple times but no record that the dentist has called. I would say something is wrong with the dentist office.

Is the dentist looking for you to now pay the bill. Is your dentist part of your dental network if you have one? You could always get a copy of the bill from the dentist and submit it yourself. Then find a new dentist.

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PostPosted: Sat Feb 20, 2010 1:18 pm   Post subject:   

Quote:
Apparently they just aren't submitting my claims for some reason and lying about it. I can't determine any reason why they would do this. Can anyone?
The only thing I can think of is a lazy office worker at the dentists office, and he/she can't hardly admit to being lazy Rolling Eyes so they blame it on your carrier. Any chance there is a new employee there handling this? Bet your carrier isn't the only one they are having problems with. Wink If I were you I'd call my carrier get the information myself, (be sure and note the person you talked to and the date and time) and give it to the person at the dentist office, (or file it yourself). Actually if the person handling this has a supervisor I'd give the information directly to them. I'd also let them know that you've talked to the carrier and NO one has called from that office.

As Das asked are they trying to get you to now pay it?

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