male only Wtf?!?!

[Nate 292]

Seeing as we're allowed to post off topic stuff here in the Man Room I figured I'd rant a while before I kill somebody.

It all started last July. I was in a car accident in an older vehicle that didn't have an airbag. You'd think my fat belly would have saved me, but nope. I ended up kissing the steering wheel and knocking out and or shattering almost every tooth in my head. When all was said and done They were able to save 10 of my bottom teeth, the top were too far messed up so what was left were pulled so I could get a full denture on top and a partial on bottom.

I was dealing with one of the major chain Dentists to get the work done. They were ready and willing to pull all the teeth and do the bone adjustments to get me ready to be fitted for dentures. They even went as far as taking casts of my jaws. After that I was told it was just a waiting game. I had to wait for them to submit to my insurance and receive approval on the dentures to get them made. So I wait. And wait. And Wait. After 3 Months I call the Dentist and inquire about whats going on. They say "Oh we're not sure, maybe they didn't get the request properly, we'll submit again." And I wait, and wait, and wait some more. In Feb I Call the Insurance Company and ask what the hold up is. They inform me that they never had any request submitted from the Dentist. So I call the Dentist and tell them. They say that they will submit the request for dentures again. And I wait. After a month i receive an approval letter from the Insurance Company saying I was approved for upper dentures. No mention of the lower partial at all.

So I call the Insurance Company. They inform me that they only received a request for upper dentures from the Dentist, no lowers. That I would need to have the Dentist submit for the lowers and they would have no problem approving them for me. I call the Dentist and have them submit for the bottom partials, and I wait. And Wait. And Wait. Call the Insurance Company yet again. They said they have received nothing from the Dentist regarding lower partials. They call the Dentist for me and give them the Fax Number of where to submit the paperwork instead of mailing it in and they tell me to call back in a month. That brings me to June when I'm being sleeved. I decide to lay off a month to recuperate and not stress over this garbage.Come July i call the Insurance Company back. Surprise! No request for bottom partials has been submitted. So I call the Dentist yet again and this time I'm told "No we're not submitting for them. We've already submitted for them too many times."

That was the final straw. I called the Insurance Company back and informed them that I wasn't dealing with this Dentist any longer and that I would like help finding a new one. They help line me up with a new one, I go in, tell them my story and they're very sympathetic and ready to make everything right. The staff even showed me as they Faxed in the request for my dentures, both upper and lowers. So I wait a month. And that brings me to this morning. I receive a call from the new Dentist's office this morning. They informed me that they received the approval for my bottom partial denture, but the Insurance Company wont approve the upper denture because they've paid off on one once already at the previous Dentist. The previous Dentist never made them!

So I've spent the last 2 hours on the phone bouncing back and forth between the old Dentist, the new Dentist, and the Insurance Company. The new Dentist is very nice and willing to work with me no matter what happens. The insurance Company told me I have 2 options. Get one denture made at each Dentist, or try to get the old Dentist to refund the payment to the Insurance Company, then once that is accomplished have the new Dentist resubmit for my upper denture. So I called the old Dentist and fought it out with them and they said their Corporate Office could take up to 6 months to review the reason for the refund and to actually refund the payment to the Insurance Company if I want to wait that long. I think it's a line of bull crap, but I'm so frustrated and want all this to end, and I want my teeth already. So it looks like I'm going to have to have each denture made at different Dentists. I'm not happy at all!

Anyways that's all. Thanks for letting me vent. I feel a little better.

[Ms skinniness 3,003]

What a nightmare! What unprofessional professionals that you are dealing with. Hope it becomes a speedy process soon. It could be a good thing because at least now,you won't have to worry about the dentures being too big because you've lost all this weight!

[Tammy310 43]

If they take payment for something that was not done, that's insurance fraud on their end. Your insurance company can just retract payment, even after the fact. I would be sure to take it up with the insurance. And then, perhaps an attorney. By the time you're done you can get uppers & lowers FREE.

Good luck to you on this and your sleeve. Prayers ~ well wishes ~ postive vibes.

[TinaMari 75]

First off, let me say I LOVE the title of your post. lol.

Anyway, that's a bunch of bull. The first dental office is fraudulent. They knew exactly what they were doing and how dare they accept payment on your behalf knowing damn well they haven't spoken to you. The audacity!!! Furthermore you need to submit a complaint to the better business bureau and tarnish their reputation by letting your story be heard on any and every website possible. That is absolutely unacceptable. I am pissed off for you. That dental office has balls the size of watermelons and lets not even mention the amount of time that has been wasted because of their incompetence!!! Bastards !

[lollyfidy1965 402]

Seeing as we're allowed to post off topic stuff here in the Man Room I figured I'd rant a while before I kill somebody.

It all started last July. I was in a car accident in an older vehicle that didn't have an airbag. You'd think my fat belly would have saved me, but nope. I ended up kissing the steering wheel and knocking out and or shattering almost every tooth in my head. When all was said and done They were able to save 10 of my bottom teeth, the top were too far messed up so what was left were pulled so I could get a full denture on top and a partial on bottom.

I was dealing with one of the major chain Dentists to get the work done. They were ready and willing to pull all the teeth and do the bone adjustments to get me ready to be fitted for dentures. They even went as far as taking casts of my jaws. After that I was told it was just a waiting game. I had to wait for them to submit to my insurance and receive approval on the dentures to get them made. So I wait. And wait. And Wait. After 3 Months I call the Dentist and inquire about whats going on. They say "Oh we're not sure, maybe they didn't get the request properly, we'll submit again." And I wait, and wait, and wait some more. In Feb I Call the Insurance Company and ask what the hold up is. They inform me that they never had any request submitted from the Dentist. So I call the Dentist and tell them. They say that they will submit the request for dentures again. And I wait. After a month i receive an approval letter from the Insurance Company saying I was approved for upper dentures. No mention of the lower partial at all.

So I call the Insurance Company. They inform me that they only received a request for upper dentures from the Dentist, no lowers. That I would need to have the Dentist submit for the lowers and they would have no problem approving them for me. I call the Dentist and have them submit for the bottom partials, and I wait. And Wait. And Wait. Call the Insurance Company yet again. They said they have received nothing from the Dentist regarding lower partials. They call the Dentist for me and give them the Fax Number of where to submit the paperwork instead of mailing it in and they tell me to call back in a month. That brings me to June when I'm being sleeved. I decide to lay off a month to recuperate and not stress over this garbage.Come July i call the Insurance Company back. Surprise! No request for bottom partials has been submitted. So I call the Dentist yet again and this time I'm told "No we're not submitting for them. We've already submitted for them too many times."

That was the final straw. I called the Insurance Company back and informed them that I wasn't dealing with this Dentist any longer and that I would like help finding a new one. They help line me up with a new one, I go in, tell them my story and they're very sympathetic and ready to make everything right. The staff even showed me as they Faxed in the request for my dentures, both upper and lowers. So I wait a month. And that brings me to this morning. I receive a call from the new Dentist's office this morning. They informed me that they received the approval for my bottom partial denture, but the Insurance Company wont approve the upper denture because they've paid off on one once already at the previous Dentist. The previous Dentist never made them!

So I've spent the last 2 hours on the phone bouncing back and forth between the old Dentist, the new Dentist, and the Insurance Company. The new Dentist is very nice and willing to work with me no matter what happens. The insurance Company told me I have 2 options. Get one denture made at each Dentist, or try to get the old Dentist to refund the payment to the Insurance Company, then once that is accomplished have the new Dentist resubmit for my upper denture. So I called the old Dentist and fought it out with them and they said their Corporate Office could take up to 6 months to review the reason for the refund and to actually refund the payment to the Insurance Company if I want to wait that long. I think it's a line of bull crap, but I'm so frustrated and want all this to end, and I want my teeth already. So it looks like I'm going to have to have each denture made at different Dentists. I'm not happy at all!

Anyways that's all. Thanks for letting me vent. I feel a little better.

Perhaps this has already been suggested here (I've not read every post), but if you call the old dentist's corporate office, and threaten them with the words "insurance fraud" I'd be willing to bet it won't take 6 months for them to review, and pay, the refund to your insurance company. Better yet, if you have a friend who happens to be a lawyer, have them make that call.

Sorry for all your frustrations....I hope all turns out well for you!!

Laura

[O.T.R. sleever 3,386]

I wouldn't even try to handle this myself. I'd contact my insurance company and ask to speak to their loss prevention officer let them know what happened. Then I'd email them your statement of with a promise that if requested you will be more than happy to mail them a signed & notarized copy. Then let them handle it.

If they request the notarized copy I'd send it Fed-Ex or UPS, or at he very least USPS certified/ return receipt requested.

Then after informing them that they paid a fraudulent claim I'd request they approve the request from your current dentist. You have invested too much of your time dealing with the idiots at the chain office already.

[caroless 18]

i'd also call the insurance board in your state. make a report.

[Heatherr 149]

Yes, definitely threaten reporting insurance fraud. You may not have to wait too long. But, seriously, what a flipping nightmare. I am so sorry you have had to go through this, and quite frankly, it's utterly ridiculous.

[Butterthebean 8,146]

That's crazy.

Plus, I gotta ask....how have you been chewing your food all this time?

[Nate 292]

I've been cutting my food into really tiny pieces and gumming/chewing with the few teeth I have left.

The more I sit here and think about the whole mess today the madder I get. I think tomorrow I'm going to call my Insurance Company and find out about about bringing the lame ass dentist up on fraud charges or something. I'm also going to call their Corporate office and raise hell.

[chitowngirl 885]

What a freaking nightmare....hope it gets resolved soon.

[Ijam75 102]

i'd also call the insurance board in your state. make a report.

^^ yes

This is a powerful option. I had a similar issue with a home owners insurance/contractor problem, it was resolved quick after contacting them.

Sent from my mobile productivity killer.

[BrickHouse 358]

Each state has a component branch of the American Dental Association. Find out where yours is (should be an easy Google search) and get them involved, too. They have a peer review process that can pull licenses. And if yours was the place that rhymes with ShmAspen, there are complaints on them almost daily.

[Nate 292]

UPDATE:

I've gone back and forth with my insurance company. Talked to everyone from supervisors, to loss prevention and fraud report people. They will allow me to get my dentures from my new dentist! They are also starting an investigation into the other dentist for charging for work they didn't do. hopefully this will all be over soon.

[Tammy310 43]

UPDATE:

They will allow me to get my dentures from my new dentist! They are also starting an investigation into the other dentist for charging for work they didn't do.

That's awesome!! Hopefully those people get more than a slap on the wrist. But congrats to you, sounds like you deserve something good.