Quote:
Originally Posted by JMintzer
Pre-authorizations mean nothing. The insurance company will tell the provider that the "pre-authorization" is NOT a guarantee of payment...
I have to deal with this all the time...
|
Maybe "pre-auth" was the wrong term? I would think when it comes to having work done on a specific tooth the insurance company has specific records of what was done and when that specific tooth was worked on previously as we experienced with Howell Dental. They first contacted Aetna and knew EXACTLY what was covered before anything was done. Tooth #5, yes #7 no because it was done 3 years ago. Obviously I know nothing about Podiatry (or dentistry) but what would be the equivalent to working on a specific tooth treated less than 5 years ago that could be denied? Seems replacing a specific crown or covering a full mouth xray for a general exam under 3 years is more specific and is clearly listed on the policy under exclusions. As an example Policy says General exam every 6 months but full mouth xray every 3 years. Dental insurance seems very specific (if one reads the policy or checks with the insurance co).