Quote:
Originally Posted by kingofbeer
According to the United document there is a $0 copay for preventive and comprehensive services like cleaning, fillings and crowns. However, I received an authorization from United that shows this:
Amount Claimed $1504
Amount Allowed $532
Patient Responsible $972
Amount Paid $532
I spoke with United today and am calling the dentist next. Looks like I need to pay $972.
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What type of procedure was it?
I was "surprised" when I first moved here and found out that dental benefits aren't as clear as they appear to me. Now, I always get a pre-authorization before I do any dental work.
I had a crown put in a couple of years ago. I don't think the dentist did a good job as it fell off twice in the first year. (I have crown that was put in about 15 years ago and it has never fallen off.)
I went back to the dentist that put the crown in and he glued it back on for free both times. However, when it fell off a third time, I thought this might not be the best dentist so I went to another dentist who was out of network. I told him that I thought the first dentist had not done a great job so I asked about putting in a new crown instead of jus gluing the old one back on. He put it in to the insurance company and they told him that there was no coverage for putting in a second crown.
I have to wait five years to put a crown in on the same tooth.
I called the insurance company and told them that I thought that their in-network doctor had not done a proper job and that I should be entitled to a new crown. She told me that no matter had bad the first crown was put on, they will not authorize a new crown until five years have gone by. I have UHC Advantage.