I received a phone call yesterday informing me that my periodontal treatment has been approved!!! I almost fell off my chair. I have an appointment to receive treatment on Wednesday; my mouth is expressing its approval by aching.
For anyone who doesn’t know, getting this approval from my dental insurance has been quite the battle:
- I was in unbearable pain in August, but couldn’t even get an appointment to see my dentist until late September
- She sent me to get a root canal for the tooth adjacent to the one that was bothering me (“Endangered Molar”)
- I saw an endodontist in late October
- He couldn’t do anything for me due to swelling in the gum above Endangered Molar
- I had to go back to the dentist, who submitted a referral for me to see a periodontist
- Unknown to me, the referral was approved in early December
- I didn’t find out about it until I called my insurance about something else in January
- I had my periodontal consultation on January 22nd
- They sent the request for treatment authorization on January 26th
- I had to call my dental insurance multiple times, finally talking directly to a supervisor, before they even acknowledged that they had received a request for periodontal treatment.
- They denied the request. Immediately. I didn’t receive the call until Wednesday March 18th, but the rejection letter was dated March 13th – the first possible day they could have reviewed it, assuming they’d only just realized they had it in the first place.
- I appealed the decision immediately and sent the periodontist’s office all the information I had from exams at other facilities (to help them build their case). I was planning to follow up with my own written appeal.
- They actually approved the request just over a week after I appealed; the letter I received was dated March 27th.
- I’m grateful that the periodontist’s office called me as soon as they received their letter and that they held the first possible appointment for me.
I’m a bit annoyed that my appointment conflicts with my group music therapy class – the one where I feel like a valued member of a mutually-supportive group. I mean I could ostensibly go to class a couple hours after receiving surgery in a quarter of my mouth… but something tells me I’m going to need some time to recuperate. I might miss my Thursday class, too. But the periodontist is only available on Wednesdays this month; there’s no way I’m waiting any longer than I have to.
At least it’s happening now, and not closer to the end of the semester when everything will be due.
I’m relieved that I don’t have to write an appeal, or take my dental insurance to court, or call them again …. hopefully not ever. It’s a huge weight off my shoulders!
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