The Old Folks Home

[CapricornFarm]

Saw the Surgeon.... No surgery.... too high risk... cant talk about it right now just so disappointed.

deb

Sorry Deb. That sucks.

 

[ronott1]

Ron, call the number on your insurance card, and talk to them. Sometimes that's all it takes. At least they can inform you of why there is a hold up on it.

I did an online form and they said:

Thank you for your inquiry. We appreciate you taking the time to contact Delta Dental of California and we want you to know that your questions and concerns are very important to us.


Please be advised that the pre-treatment estimates being submitted is for a crown on a primary tooth. Crowns are only covered on permanent teeth and your policy does not cover services for congenital missing teeth. In order to get a definitive answer to your pre-treatment estimate, the provider will need to request a re-evaluation of the denied claim. Currently the claim is being denied for the missing permanent tooth number. Please note we have 30 business days to process a claim from the time it was received.


Please do not respond to this e-mail. Should you have any further questions and/or concerns, please contact our Customer Service Center toll-free at 1-888-335-8227 or fill out another secure form.

I called them and am now filling out a grievance form with them. If that does not work, I will file a claim with the state

 

[getaclue]

I agree about filing a claim with the state, if they deny coverage.

 

[Alaskan]

Thst is SUCH a stupid reason to deny the claim....

Hope it works out.

 

[ronott1]

Thst is SUCH a stupid reason to deny the claim....

Hope it works out.

I Know! of the other 4 like this one, two of them have had crowns for years.

 

[microchick]

@perchie.girl. I'm so sorry, dear lady. But please look at it from the angle that the doctor is doing his job and is a GOOD surgeon who isn't willing to put you and your precious life in jeopardy just in order to carve a notch on their scalpel for doing a procedure that is too risky

I agree with @getalue. Plan B time. Please don't let the stress turn you to food for comfort. Stick with the diet, get up and move. And remember we care, and are here for you.

@ronott1 insurance...herd them all together, run em off a cliff. Sorry that you are getting jerked around.Not surprised given my own bad experiences dealing with insurance companies on both a professional and personal way. You will probably be forced to play hard ball with them before it is all settled. Filing a claim against them with the state agency is probably the way to go.....all to get money back in the form of a claim using the money you paid into the policy in the first place.

The funny thing is that if you hadn't paid your premium bill, how long would they have dealt with you? Think about it from that point of view and you will probably really get steamed.

Got my babies home today. One wasn't doing well when it got there. Friend got it out of the brooder and the poor little thing literally died in my hand with me gently petting it with a finger. It was so tiny. He said it was doing well yesterday, and just went down hill this morning. Our friend and I checked it over. It was thin, crop empty. No external defects. Shipping stress? FTT? Probably both. So 5 are happily cheeping away in their brooder. I had to clean up some pasty butt on two of them but they are all running around, eating, drinking and trying to get under their cuddle bear. Pictures later when they have a chance to calm down and settle in.

SUN CAME OUT TODAY! YAY!!!!!

 

[ronott1]

@perchie.girl. I'm so sorry, dear lady. But please look at it from the angle that the doctor is doing his job and is a GOOD surgeon who isn't willing to put you and your precious life in jeopardy just in order to carve a notch on their scalpel for doing a procedure that is too risky

I agree with @getalue. Plan B time. Please don't let the stress turn you to food for comfort. Stick with the diet, get up and move. And remember we'll care.and are here for you.

@ronott1 insurance...herd them all together, run em off a cliff. Sorry that you are getting jerked around.Not surprised given my own bad experiences dealing with insurance companies on both a professional and personal way. You will probably be forced to play hard ball with them before it is all settled. Filing a claim against them with the state agency is probably the way to go.....all to get money back in the form of a claim using the money you paid into the policy in the first place.

The funny thing is that if you hadn't paid your premium bill, how long would they have dealt with you? Think about it from that point of view and you will probably really get steamed.

Got my babies home today. One wasn't doing well when it got there. Friend got it out of the brooder and the poor little thing literally died in my hand with me gently petting it with a finger. It was so tiny. He said it was doing well yesterday, and just went down hill this morning. Our friend and I checked it over. It was thin, crop empty. No external defects. Shipping stress? FTT? Probably both. So 5 are happily cheeping away in their brooder. I had to clean up some pasty butt on two of them but they are all running around, eating, drinking and trying to get under their cuddle bear. Pictures later when they have a chance to calm down and settle in.

SUN CAME OUT TODAY! YAY!!!!!

I sent off the grievance today to Delta Dental. If they deny again, then I will file with the State

 

[pennyJo1960]

Sorry been away all day hugs to those that need it I hated delta dental paid them for like 8 years then they denied the claim I got the nerve to go to dentist after most my molars has fractured the Dentist said no help to do anything but take them all out new this delta wanted his say so set up to be put under get them all pulled they said okay nope paid 2700 they would not cover for extractions then had to pay 2500 for a never fit denture not mailed it back to them

 

[ronott1]

Sorry been away all day hugs to those that need it I hated delta dental paid them for like 8 years then they denied the claim I got the nerve to go to dentist after most my molars has fractured the Dentist said no help to do anything but take them all out new this delta wanted his say so set up to be put under get them all pulled they said okay nope paid 2700 they would not cover for extractions then had to pay 2500 for a never fit denture not mailed it back to them

That is terrible!

 

[bruceha2000]

Saw the Surgeon.... No surgery.... too high risk... cant talk about it right now just so disappointed.

deb

You've worked so hard for this. I hope there is a second path for you.