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Wisdom Teeth Surgery & Insurance Issue

PinkSparkle9

Senior Member
Yesterday would’ve been 2 weeks since I had all 4 wisdom teeth out. The day before swelling in right cheek increased (Thursday). Back on antibiotics and appointment Monday.

I was told by my insurance company that if all teeth were impacted it would be covered so I talk to office prior to surgery, and they said insurance would cover $3000.

That said, today I get a bill from the surgeon’s office for $3075. Nothing was covered. They put extraction not impacted as a code. Maybe that’s why?? I tried to call my insurance but no one is there on the weekends. Go figure.

Anyone deal with similar issues?

Luckily, I have an appointment first thing Monday morning so I’m hoping it’s a code issue and once they switch code and re-bill insurance it will be covered.

So frustrated!
 
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TAOEP

Senior Member
I could be wrong, but I believe that removal of impacted wisdom teeth is covered by medical insurance and removal of non-impacted teeth is dental insurance. If the procedure was incorrectly coded, that would definitely make a difference in the coverage.

I hope everything can be worked out Monday--both with your insurance and you healing.
 

PinkSparkle9

Senior Member
Thanks TAOEP for your quick response and kindness. I hope that’s what it is- incorrectly coded.

I just cried about all this. I want this all behind me and to feel myself. Still needing to ice my face for comfort.
 

twinmom95

Senior Member
It might also make a difference as to whether it was done by a dentist or oral surgeon. However, I think only oral surgeons can do impacted.

Definately follow up with their billing people. Keep notes of who you talked to and when and the basic conversation. The office should have given you a written estimate beforehand, though they always say they can never guarantee insurance coverage.

Sorry you are having such a time with this!
 
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wildflowerz

Senior Member
I was listening to something in the radio the other day about medical insurance and they said to question everything. Coding is often wrong.

It’s good that you got the bill before Monday’s appt because it might be easier to talk to someone in person.

Good luck!
 

Cat woman

Senior Member
I hope you can get this resolved. When you are feeling yucky the last thing you want is to deal with insurance. Feel better soon!
 

gradymidget

Senior Member
I would guess it was coded incorrectly. And if you checked with your insurance company prior to surgery I think it will be easily corrected.

You are lucky that medical insurance covers it. Both of my daughters had impacted wisdom teeth. Back in 2013 the medical insurance covered my older daughter’s and I think I had to pay maybe $100. Last year when my younger daughter has to have hers out medical no longer covered it. Even with a decent dental plan I had to pay $800.

We should all have become oral surgeons and not teachers.😂
 

PinkSparkle9

Senior Member
Thanks everyone! I looked online at the information about my claim and it was covered. They said I owe $369.00 so I’ll show them that and hopefully I’ll be all set.

Yes, why didn’t we all become oral surgeons? 🤣
 

Claire

Senior Member
Oral surgeon

My insurance only covered 1000 and I had to pay 1500 on surgery day. <!--eyebrow--> for my daughter's. It was an oral surgeon and went through dental insurance.
 

PinkSparkle9

Senior Member
Thanks again everyone. What a relief to find it was covered through insurance (with $369 out of pocket).

I just want this puffiness/swelling to be gone. I’m so over it.
 
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