Worst Claim Story— January 2019

This is why dental practices need eAssist, so their patients don’t have to suffer like this poor patient:

A frustrated patient’s story:

I had a root canal performed on 6/14. I have primary dental coverage through former employer with BCBS, and secondary dental coverage with current employer through Delta Dental. Claim was first filed with BCBS. The endodontist’s office then filed with Delta, providing them with the claim statement showing what Blue Cross reimbursed for the root canal. Delta received the claim on July 12. As it appeared to still be “in process,” I called Delta asking about the claim. I paid out of pocket for the services when they were performed (almost $1600). I was advised that it can take up to 30 days to process a claim. I then spoke to someone at Delta on July 26 who indicated they needed the date the BC policy became effective (over 10 years ago). I sent that info immediately. They still denied the claim and have now restarted the processing time to allow yet another 30 days.

BCBS paid my claim within 72 hours via direct deposit. What is wrong with these people that it takes a month (or two) to process a claim. They made no effort to contact me to request additional information, so the claim would have just simply been denied. It’s off because I had a crown done on July 17, and that was prior to them requesting additional information yet they processed that claim. They are snappy and rude on the phone. If the rude customer service people were out of pocket $1600 for a dental procedure, I’m sure they would like to get their money back in a reasonable amount of time. What’s difficult to understand about that? That’s what I pay for insurance for. These people are rude, inept and not worth the money paid in premiums. Buyer beware.

Dental Billing Tips and News for Pros; Edition #131


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