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Who regulates the dental insurance industry?

Discussion in 'Off Topic Threads' started by senior smoke, Mar 27, 2012.

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  1. senior smoke

    senior smoke Well-Known Member

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    Hello:
    Who regulates the dental insurance industry? Recently, I needed a root canal and the dentist office got pre authorization for this procedure from my dental insurance company. After the work was completed the dentist office billed the dental insurance company.

    I than received a bill from the dental office stating the insurance company did not pay. I called my dental insurance company and the gal said that if they receive a bill requesting to be paid, if they can not pull up the name of the person on their screen, they do not have time to research it, and the bill is tossed.

    I got a fax # and the dentist office agreed to fax the bill a 2nd time to the insurance carrier. Once again they have no evidence of any bill being received.

    This same scenario has taken place a total of 3 times and still the insurance company denies receiving any bill. I went through all the correct information with the insurance company, and the dental office and everything matches.

    I am caught between the dentist office and the insurance company as the dental office said they originally mailed the bill to them, plus have faxed the bill 3 more times to no avail.

    Who regulates these dental insurance companies, so I can call or write to them. The insurance company says that I am covered, but without the bill they won't pay. The dental office states they have had trouble in the past with this particular insurance company.
    Steve Balistreri
     
  2. Catpower

    Catpower Molon Labe TS Supporters

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    In Texas we have a "State Insurance Board" that regulates them

    Some ins companies are terrible about paying the bills
     
  3. cubancigar2000

    cubancigar2000 Well-Known Member

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    In every state it is the Stae Insurance commissioner. try one more thing - send it registered so they have to sign for it or call them and ask for an email & have that person call you back when they recieve it.
     
  4. senior smoke

    senior smoke Well-Known Member

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    Good ideas, register is what I intend to do.
    Thanks,
    Steve
     
  5. b12

    b12 Well-Known Member

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    First send the bill regisered for a signature. If refused call your state Representive or email the state attorney general and explain the problem. I have done the same thing on other issues and have had 100% sucess but it may take awhile for a response from attorney generals office. When you get a reply they will probably have a questionair to fill out. Also let you dentist know what you will be doing. Wild Bill
     
  6. senior smoke

    senior smoke Well-Known Member

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    b12:
    Good idea.
    Thanks,
    Steve
     
  7. mike b.

    mike b. Member

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    Sometimes I feel these companies do some claim dodging to put their payment into another quarter or year. Hard to prove but before I retired , I was one of those dentists who played the "game" with the insurance companies. If it was a covered benefit, you will get payment eventually. mb
     
  8. senior smoke

    senior smoke Well-Known Member

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    After school today, I went to my dental office and got a copy of the bill. I then hand carried it to the dental Insurance company and got a receipt for it. Let's now see how they get out of it now?
    Steve
     
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