Bella Zaritsky I had a Delta Dental claim that was for four impacted wisdom teeth with IV sedation. It was initially sent to Delta, but Delta required a medical EOB for these specific procedures. The medical insurance took 4 months to process the claim and send...
Jackie Koontz A patient came in on 2/11 for a preventative visit and had dual insurance coverage. After the primary insurance processed, the claim was sent to the secondary insurance — this is where the fun started. The office started eAssist services started in April, and...
Hillary Rubino “I work with an office that takes a lot of union plans, and these plans are the worst about paying out on major treatment. The doctor does a lot of onlays and there was one patient that had 4 of them denied for necessity...
Jennie Nelson “When I joined the office, a UHC claim was already at least 8 months old and had been worked a few times but to no avail. It was a pretty straight forward denial of a crown, so it should have been an easy appeal....
Diamond Sinegal “I have found that working VA claims can be very challenging. I was recently working a VA claim for one of my offices that the office had received prior authorization prior to the completion of treatment. Prior to bringing on eAssist the office submitted...
This Cigna claim took 8 months to resolve. The claim was for 3 surgical extraction and a bone replacement graft for DOS 4/19/19. It was originally billed with the wrong rendering provider, but before it paid a corrected claim was sent which showed the correct...
My eAssist team member and I had an SRP claim from June 2018 that had been denied due to "medical necessity". The office had already appealed a couple of times before we came on in Jan 2019. They received a letter just before we started...
My first office was a Medicaid practice. We had a 16 year old pt who needed full mouth extraction and dentures. It was sad. Medicaid denied all his extractions due to “frequency”. I came to find out that his last dentist billed out the full...
Here's a short fun one to share. Office had a patient whose birthday was February 29th. And, decided to do sealants as the next year they would no longer be covered due to the age limits on the plan. Well needless to say the system...
My worst claim story is for a worker's compensation claim for a patient that had an accident in 1970. The patient had to have major facial reconstruction. He lost all of his teeth on the lower arch. He has a subperiosteal implant that retains a...
