Dear UHC, Great Expressions, Medicaid and whoever else is reading:
I am writing in regard to a bill I am receiving from my dentist’s office. My dentist is Dr. Katerine Halim at Great Expressions in Woodbridge, NJ. The date of service was 10/12/2017. My dentist’s office has filed a pre-authorization and claim for my crown on tooth 12 multiple times.
The reason for the denial of the claim from United Healthcare is that the dentist has not sent postoperative x-rays, however, my dentist has sent the x-rays and has resubmitted the x-rays at least 3+ times now. I call United HealthCare and my dentist literally every two weeks and we continue to go around in the same circle where UHC claims to not get the x-rays and my dentist claims to have sent them.
In fact, this most recent time I spoke to my dentist, they said “we give up.” They then told me that they sent UHC my entire file, every treatment, every x-ray, everything they have on me, because they don’t know what else to do. They sent UHC everything and the claim was still denied.
I filed an appeal and it was denied on the basis that x-rays weren’t received, however, UHC was and has been able to receive x-rays for all of my other dental work. I’m not sure why this case is any different.
I only make $5,000 a year, this crown is more than $1,000, that is a fifth of my income. I can’t even pay that on a payment plan because I don’t make nearly enough money.
Additionally, I have been diagnosed with an aggressive myofibroma tumor in my mouth. I only bring this up because this situation is stressful and timely. I’ve spent hours upon hours upon hours making phone calls back and forth and getting nowhere. If I could hand deliver these x-rays to UHC, I would, but I’m in no position physically of financially to do so.
This bill is now going to collections and I can’t pay. I don’t know what to do. I have been put in the middle and neither side is willing to do or suggest anything different. We’re going around in a circle and the only one suffering is me.
I’ve gotten crowns before and I have never had this problem, I don’t understand why this is any different. Why should I be punished because UHC and my dentist can’t seem to communicate properly? I was never once given a choice. I was told I needed a crown. I trusted my doctor and typically the dentist doesn’t even allow me to schedule an appointment for a crown, let alone get the crown until insurance has approved it, but for whatever reason this time it’s not working.
Both sides, UHC and my dentist are not working together and my hands are tied. I didn’t want a crown, I was told I needed one and was given a crown only to be told after I got it that UHC isn’t covering it. If I could give you this crown back, I would because it has caused so much frustration.
I don’t even own anything worth $1,000. I have no assets. I own nothing. How am I expected to pay? Why should my credit suffer because UHC and my dentist can’t seem to send and receive x-rays to each other?
I have no idea what else to do and am left depleted at the end of the day. I cannot continue to spend my time and energy on this bill when I really should be using my time to treat my tumor. I am asking for your help in resolving this situation because I have nothing left to give. I have tried everything I can think of and I too have given up.