mikec

long story short, my 7 year old needs a pediatric dentist - I have aetna PPO dental thru my company - there are very few in-network providers in the area, which is a suburb of NYC....so we contact one in the city where I work, and they tell us "we don't accept people from Stratford"....not that they're not accepting new patients, just ones from my town, which is about 20 mins away.

WTF!! My company's benefits dept is following thru with this BS because it's ridiculous.... everyone I've asked has told me they never heard of this kind of denial EVER... have you?? I'm assuming the dentist hates the insurance companies or something - has anyone else ever run into a strange situation like this??????? I feel it's discrimination and am pretty pissed about it.

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Dilbert1234567

just a thought, maybe they have a limit to the distance they want patients driving home after they get put on drugs, i think they may be liable if you go drive home and crash, did you ask them why they don't?

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Menoman

Private practitioners are allowed to refuse their service to anyone they feel like it.

This is a fight not worth taking on. There are other dentists.

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pig

hey mike, also consider whether or not you want someone who doesn't want to be tending to your child sticking all kinds of sharp junk and cutting and yanking around inside his noggin. i would think the practice might be part of some sort of dental association, wherein they only take clients from specific locales. I don't know how legal that is, but I would think its not just a personal grudge.

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mikec

dilbert, this is for my 7 year old daughter, so I don't think driving home afterwards is the issue..

menoman, if the dentist is in-network with an insurance company they are not allowed to refuse service to anyone they want without cause - this has been confirmed by the insurance company and by my company's corporate benefits dept.

pigglet you're correct - at this point I wouldn't go to them...I would really hope a dentist wouldn't take a grudge out on a 7 year old kid but you never know.

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Until the 20th century, reality was everything humans could touch, smell, see, and hear. Since the initial publication of the charted electromagnetic spectrum, humans have learned that what they can touch, smell, see, and hear is less than one millionth of reality

MSD

Check if Dr. Lee in Fairfield is in your network. He's my dentist and I've never had a problem with him.

Brewmaniac

mikec, smells like big time BS, let us know how it turns out.

EaseUp

It is obvious that your dental plan is one that compensates the dentist very little. In other words, you or your employer pay a very low premium.

Let's use an example. The policy is now defunct, but Discount Tire used to fix flats for no charge. Even the most demanding customer would probably understand if they had to wait for that service until the store finished installing $1000 worth of tires for a paying customer.

In the same manner, some insurance (especially some medical plans) actually cause the provider to incur a loss when a patient shows up. Yes, it's better for the doctor (financially) if the patient never comes in. There are probably hundreds of people who wish to receive care for little or no fee, so the dentist or doctor must, of necessity, have a way of deciding how many of these patients he can absorb.

You would be wise to investigate the financial aspects of your plan. Also, unless your daughter has a political disease like AIDS, any health care provider is entitled to choose whether or not he wishes to treat her. Thus, your "discrimination" thought is difficult to understand.

Astrocloud

I would look for another dentist AND complain to the insurance company.

mikec

thanks for the reco mr selfdestruct - no in-network providers in ffld, so I think we're going to wind up going out of network, and it's always good to have someone recommended...it's like a 10% difference in price, but I was thinking about the principalities involved here heheh. plus I know most of the best dentists/doctors don't even want to deal with the insurance companies, but if you go out of network then you have to pony up all the cash up front and wait for reimbursement from insurance, which is kind of a pain.

benefits is taking my complaint letter and sending it directly to the "right" people at aetna so they can go after the dentist.

I'll definitely post an update once this is resolved!

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Dilbert1234567

i was talking about a more blanket policy...

but after you complain, go to a different dentist... it sounds like he holds a grudge.

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