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I’m Denying The Denial

October 11th, 2011 Leave a comment Go to comments

IV sedation procedure not necessary.  Coverage denied.

Those words leaped off the bill I just received from my periodontist.  So did the number $399.
Like a bull in an arena snorting and staring down a red cape, It’s amazing I was able to dial the office number without my cell phone screen fogging up.
In a restrained tone, in between deep breadths, I inquired why I my insurance wouldn’t pick up the IV sedation.  Her answer was that many insurance companies don’t pick that up.

Without being too graphic (that’s a darned good pun),  I had a piece of skin gutted from the roof of my mouth to use as a skin graft to repair a tear in my front left tooth gum.  The procedure took about an hour and I woke up with stitches in my mouth, along with putty to protect where he gouged the roof of my mouth.  That was six weeks ago and I’m still numb where doc scraped for the graft.

Not necessary?

I suppose in the old days they shot up the violated area with a local and the patient stayed awake through the whole ordeal.  It makes my stomach churn just thinking about it.

The receptionist relayed that the doctor would give a testimonial to the procedure and file the claim again to see if it’s accepted.

Now, I know people go through far worse medical procedures but this was no picnic.  Surgery anywhere in your mouth is no fun.  I also understand that there’s insurance fraud, but c’mon man.

…and don’t get me started on my medical decuctable…

 

 

 

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  1. Laura
    October 11th, 2011 at 09:38 | #1

    Dealing with Insurance and Doctor’s is very frustrating, to say the least. I was called back after my annual mammogram for more testing, since the radiologist spotted something that needed to be checked out. I got the appointment, went and all was fine…until I got the bill. The insurance did not pay becuase it was not preventative. What? You might want to stay on top of your doctor’s office to make sure they do refile that, as I have been told that before only to find out they never did. A lot of it has to do with how the doctor’s office acutally files the claim too. Good luck with your healing though.

  2. Jerry Hammes
    October 12th, 2011 at 11:33 | #2

    Insurance and medical companies are there to collect premiums and deny claims. That is what the GREED pickets are all about. Logic does not prevail in structuring needs. Take this from an 80 year old = experiences in life.
    DwywerWireDad

  3. Tammy
    October 17th, 2011 at 12:50 | #3

    Oh my!! I had this same procedure done about 10 years ago. The doctor said “it will just feel like a bad pizza burn on the roof of your mouth”. It was by far, the worst thing I have ever been thru!! I have had 2 kids, gallstones, severe diverticulitis…..NOTHING compared to this~

    Fight for it John. There is no way in heck you could’ve done that without the sedation!

  4. Ronald Knowles
    November 11th, 2011 at 13:42 | #4

    I would like to know how a person would go about posting something such as a blog for everyone to see… any help would be greatly appreciated!

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