- Jurisdiction
- New York
Hello,
I went to dentist specialist for procedure (TMJ). I have dental insurance, that DDS, is actually on the plan, but he does not accept insurance? for that procedure. His condition everything out of pocket, and I will deal with insurance on my own. I agreed, paid. I submitted claim to insurance, DDS gave me procedure codes and TOTAL for whole thing. Insurance called me, to check on some details, and asked me to itemized statement. I asked DDS to give me itemized statement for insurance, his office refused, same they did with insurance rep. who called and asked same question. Rep. was shocked, first of all, rep. told me that that DDS is on contract with them and should follow agreed price etc..., and rep. was shocked that DDS office refused to itemized. Is it even legal in NY to refuse statement request from patient? Also, on DDS agreement printed:
**I am aware my dental/and or medical insurance does not cover TMJ treatment my signature to this form acknowledges my agreement to have TMJ treatment and I know it will not be covered by my insurance plan** . Even my insurance covers it, and DDS, since he is plan provider, also knows that.
I paid in full for treatment out of pocket, but with all this insurance claim, I don't feel that DDS is "kosher", and how can I demand itemized statement from DDS, procedure cost thousands, I'm just trying return something from insurance.
Thanks
I went to dentist specialist for procedure (TMJ). I have dental insurance, that DDS, is actually on the plan, but he does not accept insurance? for that procedure. His condition everything out of pocket, and I will deal with insurance on my own. I agreed, paid. I submitted claim to insurance, DDS gave me procedure codes and TOTAL for whole thing. Insurance called me, to check on some details, and asked me to itemized statement. I asked DDS to give me itemized statement for insurance, his office refused, same they did with insurance rep. who called and asked same question. Rep. was shocked, first of all, rep. told me that that DDS is on contract with them and should follow agreed price etc..., and rep. was shocked that DDS office refused to itemized. Is it even legal in NY to refuse statement request from patient? Also, on DDS agreement printed:
**I am aware my dental/and or medical insurance does not cover TMJ treatment my signature to this form acknowledges my agreement to have TMJ treatment and I know it will not be covered by my insurance plan** . Even my insurance covers it, and DDS, since he is plan provider, also knows that.
I paid in full for treatment out of pocket, but with all this insurance claim, I don't feel that DDS is "kosher", and how can I demand itemized statement from DDS, procedure cost thousands, I'm just trying return something from insurance.
Thanks