Just a little Mis-Communication !!

I am so freaking pissed right now! And I do not even know who to be pissed at. Myself, most likely, and I will get over that soon enough. But I am also angry with the new Dental Insurance Company......and the Assistant Site Manager (where I work). and just freaking insurance issues in general....

They rejected my dental claim.....

I spent precious time on the phone trying to rectify the situation because the Representative told me if I had prior coverage, my 6 month waiting period would be waived.

I received the letter of coverage from prior dental group.....

Wrong DATES..

Received new letter with correct dates, faxed it in, waited, waited ....

Upon arriving home, I called up the Ins. Company to see if my wait period was waived and I could resubmit my dental claim for payment....

YES, we received the letter.... NO, your claim will not be paid.....

???

Turns out the prior coverage had to be with the current employer's previous dental insurance carrier, and it was not. Even though the Customer Service Professional told me otherwise... I had specifically asked if the coverage was limited to AAA's carrier... She had told me any coverage would allow me to waive the wait period, as long as I had had the coverage for over 6 months.. grrrrrrrrrrrrrrrrrrrr

Originally, we were told that we did indeed have a 6 month wait period on any service other than a routine cleaning... I was going to wait until the 6 months had passed, but here is where the story gets stupid......

The reason I went ahead and scheduled my dentist appointment is because our assistant site manager claimed she had some fillings done and they were covered. We had this conversation twice. So, I made my appointment and had some fillings put in. That is when I got denied...

Went through all that other crap.. Had the conversation with her again. She claimed that YES, her fillings were covered.

Got denied again. Back to our conversation again. This time she claims that she was discussing our dental policy from 5 years ago, and no, she has not had any work done recently..

WTF ????

I did not imagine those other conversations... I am not stupid.... I would not have scheduled the freaking appointment except she told me it would be covered....And now she says I misunderstood her... Why the hell would I be discussing some old policy when I want current treatment.....

ALAS, I am responsible for the payment..... grrrrrrrrrrrrrrrrrrrrrr..

My Bossman just called me to find out what the verdict was on the situation. I went through the whole ordeal with him, just as I have now, here... and he smells something fishy... He remembers those conversations as well, and thinks he smells a rat. So, tomorrow he is going to do a little digging and find out what is going on....

I personally think that her claim was mistakenly paid and she thinks that they will force her to reimburse the claim, if I dig around too deeply wanting answers. Therefore she changed her answer... For the life of me, I did not imagine the first 4 conversations....and neither did my Bossman........