One Small Victory

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:

1. I was in unbearable pain in August, but couldn’t even get an appointment to see my dentist until late September
   1. She sent me to get a root canal for the tooth adjacent to the one that was bothering me (“Endangered Molar”)
2. I saw an endodontist in late October
   1. He couldn’t do anything for me due to swelling in the gum above Endangered Molar
3. I had to go back to the dentist, who submitted a referral for me to see a periodontist
4. Unknown to me, the referral was approved in early December
   1. I didn’t find out about it until I called my insurance about something else in January
5. I had my periodontal consultation on January 22nd
   1. They sent the request for treatment authorization on January 26th
6. 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.
7. 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.
8. 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.
9. They actually approved the request just over a week after I appealed; the letter I received was dated March 27th.
   1. 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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