Insurance company informed me a dentist was in-network, but my claim got denied.
I recently had my wisdom teeth removed and called my insurance company beforehand to verify if the dentist was in-network. The representative assured me that the dentist was in-network, so I moved forward with the procedure. However, when I checked my claim today, it showed that the dentist is listed as out-of-network.
Has anyone else dealt with something similar?
I’m really sorry to hear about your experience. It can be incredibly frustrating when you rely on information from your insurance provider and it turns out to be incorrect. It’s not uncommon for others to face similar situations, especially with changes in networks or miscommunication.
Here are a few steps you could consider taking:
Contact Your Insurance Company Again: Reach out to the insurance company and explain the situation. Provide them with the name of the agent you spoke to if possible, and any reference numbers related to the call.
Ask for a Review: Request that they review the claim based on the information you were given about the dentist being in-network. They may have a process for escalating the claim.
Request Documentation: If the dentist was supposed to be in-network, ask for documentation or confirmation from the insurance company that supports your claim, which you can then present to the dentist’s office.
Follow Up with the Dentist’s Office: Sometimes, the dental office may also have the ability to resubmit the claim or assist you in resolving the issue with your insurance.
Document Everything: Keep a record of your conversations, including dates, times, names, and reference numbers. This information can be helpful if you need to appeal or escalate the issue later on.
File a Complaint: If you don’t get a satisfactory resolution, consider filing a complaint with your state’s insurance regulatory agency.
I hope you can get this issue resolved soon! Good luck!