hello; I will outline the keys steps with my COB insurance issue. 1.) I have a medicare advantage plan with MINOR dental benefits (Cigna) 2.) I have a Federal Dental plan with METLIFE which has most of the coverage 3. Dental office stated that maximum benefit would be from file medicare primary, Metlife secondary 4. After processing, the medicare plan paid very little BUT the office charged me according to their fee schedule which was $3116 5. ) The metlife plan is ALSO in network, After processing the met life plan stated I was overcharged by $937 for my up front cash payment. I have the EOB and a statement from the Metlife plan. 6.) The Dental office states that the fee schedule from cigna is the only one allowed 7.) The dental office refuses any refund whatsoever. The dental office and Dr Chilcoat's staff state that they will not honor the in network fee schedule of the Metlife dental plan which they are In network with. The Office staff had suggested that I file the insurance through the medicare plan as primary payer to maximize my benefit. Now they state that the fee schedule through the metlife plan will not be honored and the medicare fee schedule is final. The medicare plan has only very minor coverage and is a free plan with my medicare advantage plan. I pay over $1000 per year for the metlife coverage and now they say I can not fully utilize those benefits because they filed medicare as primary. They asked for payment up front and overcharged by using the cigna medicare fee schedule. Now they refuse to honor the contractual agreement with the (in network) METLIFE plan. Metlife has sent them a request for a refund of my overpayment. I can supply that request if needed.
here is what the office stated . keep in mind that they actually sent the initial charges from their off to the metlife plan from their office and I have the fax. therefore an time they say they were not aware that I had a secondary insurance is an outright lie. here is the email response in quotes. ", from what I am being told, Be cause we only had Cigna on file from the time of your extraction and bone graft and you submitted to Metlife on your own, according to the Cigna fee Schedule we collected correctly, and there is no Difference, we cannot reimburse you, because you have already been reimbursed by Metlife, and We cannot adjust fees after Claims were submitted by you individually. Metlife again was not primary at the time of your procedure, so we would have to base the cost off of Cigna". It is all a scam to charge me more and to deny my right to fully utilize my high dollar IN NETWORK dental plan
I had my work done at the old Monarch in the mall on Towne East Blvd. in 2011, that isnt there anymore as I'm now starting to see a pattern of doctor and location rotation from Monarch that is pretty common of there revolving door dentist and location. The dentist that performed my dental work "decided" he would perform two root canals on my upper front teeth, before crowning them " just in case they started hurting later" and needed root canals. This was around the same time that I'd just been approved for Smiles Brand Financing, and a Care Credit Card which the dentist took no time at all maxing out with these unnecessary root canals on teeth that were never in any pain before, weren't that decayed to need this excessive work on, before crowning with needed bridgework. I, too trusted the dentist judgement on what my mouth needed work on medically and cosmetically.
I wish now I had shopped around dentistwith my Carrington Dental plan instead of just picking a dentist that was close to home.
My dental bridges lasted until just last summer of 2016 when the entire five tooth crown upper fell out while eating oatmeal for breakfast. Retook out the Carrington Dental plan and headed back to another Monarch to see if it could be recemented, and guess what? The very front upper right tooth that had the unnecessary root canal done on it was so fragile, what was left of it broke off into the hulled out hole of the crown that came off and it had to be dug out of the crown while this new dentist at the new Towne East Blvd. location, preceded to reattach my old five tooth crown with the flimsiest sealant known to man.
The tooth bridge lasted about seven minutes after we got back home before falling off and out of my face! He may have used a crappy sealant on purpose due to my financial situation at the time. He initially said the cost to do this simple task would be about $110 dollars, im not even kidding you. My mother was with me as I'd had a stroke in July of last year and was still having trouble driving and was out of work, at that time and she said she'd be paying for the X-rays and exam, but didn't have that kind of money at which time he said he'd put it back in for free, over the broken tooth, no less! He also had the audacity to turn an already bad situation i was going through into an embarrassing moment for me when he referred to my current no toothed look as saying I " was going around looking like a hillbilly"! Thanks, dude. I already feel like I look like crap enough most of the time due to the facial paralysis I still suffer with from the stroke I had to not have to be reminded by you that I resemble some lower form of humanity in your opinion! This Monarch Dental he was at wasn't the old one that used to be in the mall, it is still on Towne East Blevins, though, it's behind the Jack in the Box, where the old Service Merchandise used to be). The doctor there is Indian, but does not speak with an Indian accent.
Monarch Dental Reviews
hello; I will outline the keys steps with my COB insurance issue. 1.) I have a medicare advantage plan with MINOR dental benefits (Cigna) 2.) I have a Federal Dental plan with METLIFE which has most of the coverage 3. Dental office stated that maximum benefit would be from file medicare primary, Metlife secondary 4. After processing, the medicare plan paid very little BUT the office charged me according to their fee schedule which was $3116 5. ) The metlife plan is ALSO in network, After processing the met life plan stated I was overcharged by $937 for my up front cash payment. I have the EOB and a statement from the Metlife plan. 6.) The Dental office states that the fee schedule from cigna is the only one allowed 7.) The dental office refuses any refund whatsoever. The dental office and Dr Chilcoat's staff state that they will not honor the in network fee schedule of the Metlife dental plan which they are In network with. The Office staff had suggested that I file the insurance through the medicare plan as primary payer to maximize my benefit. Now they state that the fee schedule through the metlife plan will not be honored and the medicare fee schedule is final. The medicare plan has only very minor coverage and is a free plan with my medicare advantage plan. I pay over $1000 per year for the metlife coverage and now they say I can not fully utilize those benefits because they filed medicare as primary. They asked for payment up front and overcharged by using the cigna medicare fee schedule. Now they refuse to honor the contractual agreement with the (in network) METLIFE plan. Metlife has sent them a request for a refund of my overpayment. I can supply that request if needed.
here is what the office stated . keep in mind that they actually sent the initial charges from their off to the metlife plan from their office and I have the fax. therefore an time they say they were not aware that I had a secondary insurance is an outright lie. here is the email response in quotes. ", from what I am being told, Be cause we only had Cigna on file from the time of your extraction and bone graft and you submitted to Metlife on your own, according to the Cigna fee Schedule we collected correctly, and there is no Difference, we cannot reimburse you, because you have already been reimbursed by Metlife, and We cannot adjust fees after Claims were submitted by you individually. Metlife again was not primary at the time of your procedure, so we would have to base the cost off of Cigna". It is all a scam to charge me more and to deny my right to fully utilize my high dollar IN NETWORK dental plan
I had my work done at the old Monarch in the mall on Towne East Blvd. in 2011, that isnt there anymore as I'm now starting to see a pattern of doctor and location rotation from Monarch that is pretty common of there revolving door dentist and location. The dentist that performed my dental work "decided" he would perform two root canals on my upper front teeth, before crowning them " just in case they started hurting later" and needed root canals. This was around the same time that I'd just been approved for Smiles Brand Financing, and a Care Credit Card which the dentist took no time at all maxing out with these unnecessary root canals on teeth that were never in any pain before, weren't that decayed to need this excessive work on, before crowning with needed bridgework. I, too trusted the dentist judgement on what my mouth needed work on medically and cosmetically.
I wish now I had shopped around dentistwith my Carrington Dental plan instead of just picking a dentist that was close to home.
My dental bridges lasted until just last summer of 2016 when the entire five tooth crown upper fell out while eating oatmeal for breakfast. Retook out the Carrington Dental plan and headed back to another Monarch to see if it could be recemented, and guess what? The very front upper right tooth that had the unnecessary root canal done on it was so fragile, what was left of it broke off into the hulled out hole of the crown that came off and it had to be dug out of the crown while this new dentist at the new Towne East Blvd. location, preceded to reattach my old five tooth crown with the flimsiest sealant known to man.
The tooth bridge lasted about seven minutes after we got back home before falling off and out of my face! He may have used a crappy sealant on purpose due to my financial situation at the time. He initially said the cost to do this simple task would be about $110 dollars, im not even kidding you. My mother was with me as I'd had a stroke in July of last year and was still having trouble driving and was out of work, at that time and she said she'd be paying for the X-rays and exam, but didn't have that kind of money at which time he said he'd put it back in for free, over the broken tooth, no less! He also had the audacity to turn an already bad situation i was going through into an embarrassing moment for me when he referred to my current no toothed look as saying I " was going around looking like a hillbilly"! Thanks, dude. I already feel like I look like crap enough most of the time due to the facial paralysis I still suffer with from the stroke I had to not have to be reminded by you that I resemble some lower form of humanity in your opinion! This Monarch Dental he was at wasn't the old one that used to be in the mall, it is still on Towne East Blevins, though, it's behind the Jack in the Box, where the old Service Merchandise used to be). The doctor there is Indian, but does not speak with an Indian accent.