A few days before Christmas, I developed a toothache. I went to our local
provider (Charlotte County Health Department), who informed me that I
needed the tooth removed by an Oral Surgeon, due to an infection. He
could not do it, and gave a me a list of reasons. Reasons such as "we're
closing for the holidays in an hour". Now, I have survived Sepsis back in
2014, and open heart surgery, during which I received an artificial Mitral
Valve. I have tooth infection, plus a a history of Mitral Valve replacement
and Sepsis. Anyone with a medical background knows I am at big risk
with a tooth infection. So the Dentist at Charlotte County Health
Department sends me home with a prescription for a ten day supply of
clindamycin, and refuses pain meds because of an "opioid crisis". He
also informs me that he couldn't work on me anyway, without a prior
approval from my primary physician, and a separate approval from my
insurance, Molina Healthcare.
So I call my primary, which is North Port Health Center. I tell them I
urgently need an approval, due to my pain, and the risk due to my heart
condition. I leave a voice mail, stressing the urgency of my situation.
North Port Health Center never calls me back. I then call Molina
Healthcare. They put me in touch with "Dentaquest", whom they say is
my dental insurance provider. Dentaquest gives me the names of two Oral
Surgeons, that will take my insurance. They are the only two within an
The first one, "Great Expressions", in Ft. Myers, tells me that they have not
actually had an oral surgeon there for some time, so they cannot help me.
The second one, "Coast Dental" in Cape Coral, takes my info, verifies my
insurance by having me give my member ID, etc., and schedules an
appointment for January 3rd, 2019, about a week and a half from the day I
called them. It was the best I could do, so I took the appointment, and
continued taking the antibiotics.
At about One O'Clock in the afternoon of January 3rd, the day of the
appointment, Coast Dental of Cape Coral calls me and says "Sorry, we
don't take Molina Insurance, as of the 1st of January". Yes you read it
right. Two and a half hours before the appointment that I had counted on,
and scheduled mine and my families time around- "sorry, no appointment
for you. Bye".
I then call Molina Healthcare and ask what I was supposed to do. I need
the tooth out, I waited and took the meds, and now there is no oral
surgeon that will see me. Molina refers me back to Dentaquest. The
Dentaquest automated phone system takes my insurance info, then has
me on hold for 2 hours straight, before hanging up on me. I call back,
and eventually get a live person, and I explain the urgency, with my tooth,
my history, my heart, etc. The person refuses to identify themselves,
and they tell me that they need to figure out why I "have two health plans
in the State of Florida", and if I am "supposed to do that". They refuse
to discuss my urgent need, my pain, and the fact that they sent me to
oral surgeons that either don't exist or were about to drop Molina from
their coverage plan.
I tell the person that their paperwork is not my problem, and that I just
need to see someone. They try shouting me down, as I explain about
my heart. Then they hang up on me. (Yes, I recorded the conversation)
I then call Medicaid Administration in Florida, who tells me they can't help
me until my grievance with Molina is resolved (could take 3 days), and then
after that, a Medicaid investigation (could take another week to 10 days).
They say I need to call Molina back, and have them straighten things out.
I call Molina back, and they say they have nothing to do with dental care at
all, but they will call Dentaquest for me anyway, straighten out their
coverage issues, and they will call me back with all the information I need
to be seen. They have not called me back. Why am I "shocked"?
I am nearly out of antibiotics, my tooth hurts, no one will see me, and I am
very concerned about my heart.
It's 10:00 am on the 4th of January. No one has called me.
North Port Health Center failed to call me back, when faced with an urgent
request. Charlotte County Health Dept., should have treated my tooth. It
was medically necessary. Molina has not followed through with promised
info. Coast Dental failed to inform me of their intention to drop Molina,
thus extending my pain and increasing my risk for Endocarditis.
Dentaquest- where to begin with them? Knowing the risks I face, they
sent me to two providers, one that was not an oral surgeon, and another
that was about to drop the insurance plan. During the first call to
Dentaquest before Christmas, they either knew or should have known that
Coast would not be able to help me after January 1st. On the second call
to Dentaquest on January 3rd, they shouted me down on the phone and
hung up on me, when I insisted we deal with the provider issue, rather
than their perceived "two plans" fantasy.
The state of Dentaquest's knowledge of my case as of the time of this
writing, is that I am in need of an urgent tooth extraction, I am in pain, and
at risk for severe heart complications, and they have hung up on me rather
than provide an accurate list of Oral Surgeons that will take my insurance.
My guess is that they should not be doing business in the State of
I have no one left to call, no provider, no nothing. I am nearly out of the
antibiotics that I have been on since before Christmas, and am not feeling
well. My head hurts constantly from the tooth, and I am scared of having
my heart go bad again. I would be doing something to take care of my
tooth if I had any more choices, or anyone else to call, instead of taking
the time to write this out. I really don't know what to do next.