Thursday, May 03, 2012
Today has been a pretty infuriating day, but in a good way. I'm sure that doesn't make a whole lot of sense, but let me explain.
I am embroiled in a battle with my dentist. I have never left this dentist's office without being supremely upset, but up until this week I always assumed it was my own fault. I had an appointment Monday in which the dentist told me I had to get a total of 5 crowns, and the only crown my insurance would cover was the "cheap, unreliable all-metal crown". I said, "Welp, Dentist, that's the only thing I can afford so sign me up. You are well aware of the fact that I am the only income in my household and I'm still paying off the work you did last year, so fully-covered, cheapo crowns it is".
She then proceeded to scare me with all the cons of these cheapo crowns, and how it was likely they wouldn't last a full five years, in which case I would have to have them replaced and pay full price. She told me all the horror stories about how they'd stain my gums and break and all manner of upsetting, Boy-It-Sucks-Not-To-Be-Able-To
-Afford-Quality-Dentistry news. I asked her what sort of logic there was behind my insurance ONLY covering a crown that wouldn't last and that I'd have to replace at full cost in a few years.
"I know, it's tough, insurance is like that."
Well, frankly, she upset me very much. In fact, I started crying IN the damn dentist's office, from the overwhelming sense that I was doomed to never escape the pit of Expensive Dental Work even though I have insurance. I left without committing to any treatment. My frustration snowballed into a massive panic attack, the brunt of which my husband had to survive, and for two days after I just felt hopeless and depressed. I have anxiety. This is not a new feeling for me. And again I was happy to assume it was MY fault.
Well, then I started thinking there really IS no logic in my insurance covering faulty crowns and nothing else. So I requested a new copy of my benefits book and looked it up.
Just about EVERY type of crown -- including the fancy, all-white, super reliable porcelain ceramics -- is covered by my insurance.
Surely there must be a mistake. She couldn't have just LIED to me, could she have? I called her office to ask for the billing codes, just to be sure I was looking up the correct procedures.
She ducked my call. I called back and her assistant gave me the codes but assured me she would call me back today with the full breakdown. That's okay, I assured her, I just wanted to be sure of what the codes were.
And again... every single one is in fact covered.
"Oh, but there's limitations and exclusions. You have to think of those," said Ms. Assistant.
I looked up the limitations and exclusions. Not a one applies to the treatment my dentist is proposing.
At this point things are looking rather shady, and I'm starting to suspect I've been had. Just to be doubly doubly sure, I called my benefits provider. I called the TWICE. I spoke to two separate representatives, just to be triply sure (did I mention I'm also OCD?).
"No, there's no reason you would have any copay for any of those types of crowns," both representatives assured me. "If you get the all-porcelain it is fully covered. The exclusions don't apply to either of the two teeth you are having crowned."
Well now. That's odd.
I called back the dentist (who never did get back to me), and suspiciously enough, she's in yet another meeting. But she'll email me the breakdown, assures Ms. Assistant! And, also, the dentist suspects perhaps there was a mistake in my initial estimate so she's going to call my insurance and double-check.
So at this point I'm pretty furious. But it's GOOD to have an honest-to-goodness, identifiable SOURCE for this anger. I'm 99% certain my dentist just outright lied to me and she knows I've caught her. She's ducking my calls until she can find some way to spin this.
Well, I've got the spin right here: my insurance provider has very clearly explained that the procedure and materials are fully covered. The dentist will now explain WHAT her "copays" really are and WHY she thinks I am going to pay them. She will perform the procedure that my insurance provider has outlined for me and she will submit a pre-authorization beforehand. If she refuses to do that, I'm finding another dentist.
If she doesn't refuse, once she's placed the crowns, I'm finding another dentist.
And I'm putting this story on every review site I can find where her office has a listing.
You do NOT put me into a panic attack, KNOWING my situation, KNOWING my medical history, with a blatant and flagrant LIE so that you can cash in on my misery. OH no.
We are going to have WORDS, Dentist Mine.