Search results

@anthompson87 PA's are a pain in the ass, but the doctor should certainly be handling this is in a timely manner. I would call the office and ask for the next available appointment. Don't mention it specifically when making the request, but use the appointment time to discuss the importance of...

@anthompson87 You can file your own appeal. Can I ask how many office visits you have had for your son in the last couple of years? I ask, because your doctors frustration might be with uncompensated work. Insurance does not pay for their time dealing with PA or appeals. However, they do get...

@av3nger Yes, which is why I described it as being in violation of their contract. Hell, I even put fraudulent in quotes. The point is that the front desk is likely just regurgitating what management has told them. If the provider is in network and is aware that the patient has in network...

@allaneparker There is a serious breakdown in communication somewhere. It would be "fraudulent" to do a cash pay if they know the patient is in network. The more apt description would be to say the provider would be in violation of their contract, but the "fraud" is probably the way they...

@teelea68 Our practice dropped Cigna because their fee schedule did not even cover expenses for an office visit.

@veronica3 Yes, you are responsible for billed services that generate a patient balance.

@veronica3 Wait. The not billing a service to insurance is new information. You can certainly have them do so if you want. The end result may be the same, but if you request it they should bill insurance. If they do not, you can call your insurance and have them contact the office on your...

@veronica3 There is absolutely no way an office manager was going to agree to commit insurance fraud on your behalf. They would risk it all by doing so. If you wanted to split the cost between service contract years, it would have been your responsibility to have the services actually done...

@veronica3 So, all the visits and procedures took place in 2023?

@veronica3 In my experience, dental insurance is not really "insurance" in the classic sense. It is more of prepayment for certain services with a relatively slight discount on others. Unless you are only doing your annual check in/cleaning, you are always going to have out of pocket expenses...