Insurance?

Message

#1 Post by **NKovaci88** » Mon Jun 25, 2007 10:10 pm

Okay, so I went to my ortho. in April where he examined my teeth and suggested braces. We discussed the cost, and he told me he would send a few pictures to my insurance company where we would find out if they would cover any of the payment. I was told it would take about 4 weeks for them to reply.

SO, close to 3 MONTHS later, I still haven't heard back from my ortho.! I called in last week to check, but they say they haven't gotten anything back from the insurance company.

This is very frustrating. I wanted to get them ON and OFF as quickly as I possibly could, but this whole situation with my insurance company is taking forever. My ortho. said "your situation is not an emergency, so it would be better to just wait". Ugh.

Has anyone gone through a similar experience? Anyone have any idea why it's taking so long for my insurance to come through? Is there anything I can do?

#2 Post by **acehigh** » Mon Jun 25, 2007 10:20 pm

I had to wait several weeks for sure to find out about the insurance on my braces. But 3 months???

That does seem a bit too long. Is there any way you can personally phone the insurance company yourself and inquire about this? Also, it doesn't matter whether your case is an emergency or not. I mean, how many emergencies are really out there? Most of us either just want either straighter teeth, or a correct bite, etc. (I would guess the people having to go through surgery would be considered an emergency seeing it involves more than just braces.) I would make a phone call.

#3 Post by **GinaLime** » Mon Jun 25, 2007 11:47 pm

I got five ortho consultations. The two that checked with my insurance had it done within two weeks. You would think that the ortho would want this information as soon as possible (the quicker it gets done, the quicker he starts getting paid). I would ask him what's up, and depending on his answer I would consider getting a second ortho consultation.

By the way -- the very first ortho I went to said my insurance wouldn't cover any of the cost at all because I was too old. But it turns out they do -- they're covering $1,500 of the cost of my braces, even though I'm 24. I don't know what was up with the first ortho, but always be wary.

#4 Post by **LaaLaa** » Tue Jun 26, 2007 3:39 am

Wow, 3 months seems way too long a wait.

You should definitely try to call in the insurance company yourself and see if you can speak to someone about your case directly instead of waiting around your ortho or dentist to give you a call back about it. I would also suggest looking up other ortho's in your area that do accept your insurance. This is actually the way I found my ortho and it actually worked out wonderfully because I found a great ortho on the very first consult AND without any worries about whether or not our insurance will cover any cost.

#5 Post by **Laurie** » Tue Jun 26, 2007 9:03 am

Yep, I'd be on the phone to the insurance company.

#6 Post by **iBorg** » Tue Jun 26, 2007 11:39 am

I would be on the phone to the insurance company as well as other orthos. If this one will let you fall through the cracks, so to speak, before he has your money, how will he be once you've signed a contract and are paying him on a regular basis?

This would be a caution flag for me.

Mike

#7 Post by **hd2755** » Tue Jun 26, 2007 5:44 pm

hello,

first of all you should consult your benefits handbook which should explain your total benefit for ortho coverage. I work at The Home Depot and I receive 2,000 in total ortho benefits, this is in the handbook. the only thing they did not pay for yet is the digital photos the ortho took of my facial features and my bite aspect which was 65.00. then after that call your ortho and see if he/she is a par provider or non par provider or in/out of network which could affect payment for services rendered. then get ahold of ins co and give them the info and to expect to have charges comming in for benefits payout for your coverage. the next thing is get in the chair and enjoy your flight to braceland and land in the debtville junction village.
hope this helps.

louis

#8 Post by **SDFD TSchott** » Tue Jun 26, 2007 8:02 pm

Hey Louis glad to see your still online

lol I'm just kidding....

Anyways as Louis stated I also work for Home Depot and have $2,000 off the cost of my braces. I will be leaving home depot in 20 days and go to the state of california benefits as I will be working for the federal division for the San Diego County fire department.

Anyways my braces are paid for in full and I no longer have payments left!

~Tim~

#9 Post by **samantha_lou** » Tue Jun 26, 2007 10:09 pm

I often used to check patients eligibility for ortho coverage, as long as it was a week day it was done within minutes usually - either over the phone, or by recieving a fax from the insurance company. Definitely no need to wait three months. I would definitely check back with the ortho, I feel they need to offer to you better customer service than just leaving you hanging!

#10 Post by **Carolinahigh12** » Wed Jun 27, 2007 8:16 am

I agree with everyone on this one... Do you still have your information on benefits for 2006-2007 from your job? We recieve the information during enrollment and we can access the information on the web at anytime. You should also be able to contact HR for information pertaining your benefits.

The ortho that I go to does not accept insurance payments but will file the claim for me inorder to recieve reimbursment. I have Delta Dental and I have a 1500 coverage for braces. I will be paying my deposit upfront which is 1450, file my claim for 1500, and delta dental will send me monthly checks until they pay out the total 1500.

If the insurance is not accepted, then ask what are your other financing options, or speak with a benefits associate to locate an ortho that is a participating member and excepts direct or indirect insurance payments.

#11 Post by **Dimples** » Wed Jun 27, 2007 9:52 am

Hi,
I too think you should consider treatment elsewhere, because like someone already posted, if they are treating you this way before your treatment even started, how will you be treated AFTER treatment starts?

And I agree with laala, I too found a great ortho through my insurance, on the first try. I had 4 consultations lined up, with him being the first. After my consultation with him, I said this is it, and cancelled the other 3. He is a great ortho. Friendly, takes the time to explain things, always open for questions, always making sure if I HAVE any questions or concerns, and down to earth and easy to talk to. His assistant is great too!
And I found him through my insurance company. My insurance paid 2100 of my treatment cost.
So try looking at your benefits handbook or calling your insurance company, and see what ortho's are in their network.

3 months is a long time.

#12 Post by **NKovaci88** » Wed Jun 27, 2007 5:42 pm

Thanks for the replies.

Honestly, I REALLY don't want to change my orthodontist at this point. My dentist recommended him to me, and I was assured he was one of the best. I don't think it'll be too much of a problem once the braces are on, but waiting for the insurance to come through is killing me.

I called in again yesterday, and they said they'd try to find out what was going on and call me back. If I don't hear back from them soon, I guess I'm going to have to call the insurance myself or just change my ortho.

One thing that worried me though, was that the day I went in for my consultation, the place was PACKED. He clearly has a lot of patients. The two girls that were working at the desk both looked as if they were doing a million things at once.

BTW -- I'm 18, so I'm actually (supposed to be) covered by my parents' insurance. I don't know if this has anything to do with why it's taking this long, but I doubt it.