8 Apr, 2021 → by ClaimboUser322549
bridge for #29, #30, #31
1
I had tooth #30 extracted due to a fracture which had formed a large abscess. The dentist files a pre-authorization for a bridge which my plan does cover. The bridge was denied but the core buildup on #29 and #31 were approved which is absurd because if I weren't getting a bridge those 2 teeth would not need work. I called DentaQuest to find out why this was denied and to file an appeal on 03/19/21. I was told to check back on T, 03/23 but I waited until 03/24/21. when I called the member # [protected] I listed to the prompts and it said claim [protected] was approved and listed 2950 #29 approved, 6740 #29 approved, 6245 #30 approved, 2950 #31 approved, 6740 #31 approved. I then spoke to a representative to confirm this and to know my portion which I was told would be $410.75. I then called my dentist to schedule the work which was done on 03/30. The office had not received the pre authorization so on 03/31 I called denta quest to have them send over the authorization and was told there wasn't one. I explained I just called yesterday and was told the preauthorization was accepted and they even told me what I was responsible for. When I check the automated phone it tells me it was accepted and list all 5 codes. Now I had the work done because someone there told me everything was fine and you are now saying there no pre-authorization on file and no record of me speaking to anyone on 03/24. I have literally called everyday since then. the same approved message is on the automated machine I have temporary crowns in my mouth and now I am not sure if or when this will get approved. This is a real mess and has caused me anxiety when it shouldn't have. someone did not do their job and it causing me problems. this needs resolved.