Those two bills were submitted to my Medicare Insurance Aetna and were denied because the person who performed the cleaning was not registered in the Network for that particular branch (Aspen Dental in Dania).
According with the Fee Schedule from Aetna, the service render on 10-5 and 10-13 were in the approved CPT codes and my co-payment was $0.00, but I was asked to pay before the service was done $465.00 with the understanding that I was going to receive it back when the Insurance paid the bills.
Since October 2022 to this day, I have been in contact with the Supervisor and other person in charge of the accounts and always I have received the same answer "We are working on it, do not worry."
Aetna has closed the Appeal and Dispute, and I brought those papers to the Aspen, but as today, have not received any call or explanation.
Why I have to pay for the cleaning that is cover by Aetna 100%. If the Technician was not in the Network, it was not my fault, I do not have to pay for someone else mistake.
Otherwise, I am very happy with the dental/medical service received.
If you need additional information, please contact me at [protected] or e-mail: [protected]@hotmail.com
Thank you and hope to hear from you soon.
Note: unable to attach the EOBs from the insurance.
Claimed loss: $465.00
Desired outcome: Reimbusement