Todays / Billed for Appliance
As a new patient in this dental office and using my Aetna dental benefits for the first time a problem was created me, I now have a bill for $334.00 for a nightguard that I can not afford. I have not picked up this appliance.
On the day I was to have my 6th month cleaning. The dental hygienist had begun my examination. Upon the examination she diagnosed that I had a case of teeth grinding and clinching. The hygienst asked if I wore a nightguard and I told her that I did not own one. She then asked if I would like to have a nightguard made to help protect my teeth. I told her yes but ONLY if my insurance carrier would cover the appliance. She said she would ask the insurance clerk to verify the coverage with Aetna for the nightguard. The hygienist had stated that if I did not have coverage that I could purchase an inexpensive appliance at Walmart for around $20. As I was sitting in the dental chair awaiting my cleaning, the hygienst informed me that the insurance clerk had said that Aetna would cover the nightguard at 80%. I was then fitted for a nightguard and I paid the 20% balance. A couple of weeks later I returned to this dental office and I was told that Aetna had declined the 80% coverage of the nightguard. I was then told that the office would write the appeal to pursuade Aetna to reconsider and I was given a statement for $334.00 for the nightguard. When I arrived home I called Aetna dental and I was told by the customer service rep. that the reason it was declined because nightguards was not part of the contractual agreenment between the employer and Aetna. I then asked why the dental insurance clerk had given me information that was the complete opposite. After I questioned this repeatedly, he said that they document all verifications and it was stated that nightguards are not covered. After several calls to the the office mgr. I was assured that Aetna had stated "yes the nightguard was a covered appliance". I said that it was not fair that the patient was caught in the middle. The office mgr. said that she would talk to the dentist. It has already been a week and I have not had a call back. I then receive a letter stating that in 15 days my checking act. would be charged $334.00. I asked Aetna to send me a letter verifying my coverage and what was stated to the insurance clerk.
It will soon be the 15th day, should I close my checking account and/or speak to the dentist? By the way the dentist's wife runs the office.
The dentist seem care genuinely for his patients. I do not know if he is aware of this problem.