A lot of times, people are under the impression that when it comes to dental problems, their dental insurance has got them covered. But this isn’t always the case. Dental insurance companies try their best to avoid losing money, despite all your premiums being paid.
Perhaps you are aware that your health insurance policy does not cover your dental benefits. You only pay for your health issues and hospital bills through that. Of course, In order to cover dental care, you need separate coverage from a dental insurance company.
To Learn What To Do When Dental Insurance Won’t Pay?
Most of the dental benefits from insurance companies just cover basic benefits such as mouth cleaning twice a year and a few small issues like teeth removal, etc. They deny transplants and sometimes even fluoride treatments.
As a result of these factors, there is a high possibility that your dental insurance company will deny your claim and refuse to compensate you. Here’s what you can do at such times-
#1. Know what your dental insurance covers
Education is always the key. You’ve to be aware of all things your insurance plan covers. Do not simply listen to the sales executive. But read the whole document carefully before buying your insurance. Or visit dental offices, otherwise, dental insurance won’t pay for you.
Also always keep the copies of the document, if possible the e-file will always be available at your disposal. Do not simply skim, but know what you’re paying for. This can avoid major misunderstandings for customers, resulting in preventing any sort of trouble.
#2. Call dental insurance customer service
Call the customer service of your dental care insurance company and provide them with as much detail as possible about your claim and insurance number without hesitation. Keep the insurance documents handy while talking to them. By doing so, you will save time on the phone.
If they reject your claim and say that insurance won’t pay, ask for what details they’ll need to approve your claim. Remember, most of the customer service does not have permission to hang up the call. Keep them on call as long as you can and provide every bit of details to get your claim approved.
#3. Ask for escalation if they say that insurance won’t pay
Do not quit after trying once or twice. Ask the customer service team if there is any escalation procedure to get your claim approved. There are ways to escalate things to a higher office in most companies that consumers are unaware of. Those teams with proper documentation should be able to help you out with your dental benefits.
#4. Follow up
First of all, you can keep calling and following up with the company. And then keep asking the status of your claim once you have a ticket generated. Keep the ticket number handy. Be sure to note down the names and the times of your conversations with the representatives. Every call is recorded in the system of companies. These notes will help you explain and get updates on your claim.
#5. Take legal help if the company refuses to pay
When the company refuses to pay, you can file a complaint with the consumer court. You’ll need to have all the documentation, premium’s receipts and your medical reports to strengthen your case.
You have got the right to file a lawsuit when the company won’t pay. If you win, the insurance company has to pay your medical bills and has to compensate for all your troubles.
Companies try to avoid lawsuits because that puts a dent in their reputation. There’s a high chance that they won’t let you go to the court and negotiate outside.
See Also…
Things You Need To Know About How To Become An Insurance Agent?(Opens in a new browser tab)
Learn how to negotiate a settlement with an insurance claims adjuster?(Opens in a new browser tab)