The Tooth Of The Matter Is, They Suck

, , , , , , | Healthy | January 22, 2020

Around mid-October, I begin to feel pain on the upper side in the back of my jaw. I didn’t have my wisdom teeth out as a teen, so I know I’ve waited too long to have them removed. At this point in my life, I’m on state Medicaid; I find a dentist who takes my insurance and see them in early November. The dentist confirms it’s my wisdom teeth coming in and refers me to an oral surgeon, as the X-rays indicate that all four are bone-impacted. 

I call the oral surgeon’s office and get an appointment for December 28th. It goes well; they take another set of X-rays that informs us that the roots of my top wisdom teeth have grown into my sinus cavity. The bottom two are close enough to my nerve that he wants all four extracted, I will have to be anesthetized for it, and they need to come out ASAP. He assures they’ll submit the paperwork and the insurance will get back to me within two weeks. 

I leave satisfied. 

Two weeks roll around, nothing. I give calling the insurance an extra day, due to Martin Luther King, Jr. Day. They inform me that they have no record of any submission at all. They call the oral surgeon’s office and assure me that the office will resubmit the paperwork. I ask her how long it will take — by this point, one wisdom tooth has partially erupted; the other side of that tooth is pushing on my last molar — and am informed if the office submits online, it will take two days. 

I then call the oral surgeon to find out how they might be submitting the paperwork, so I can find out how long I’m going to be in pain. I speak with a lovely woman who, in response to my question, replies, “I don’t know,” and hangs up on me. I call back immediately; it goes straight to the office message.

I call the insurance company back and ask if anything can be done. At this point, I can only wait for them to submit the paperwork, but I am urged that if they don’t, to contact state Medicaid and make a complaint. 

I wait 24 hours and call the surgeon again. This time I get another woman, who is actually helpful. Surprise, surprise, no one submitted my paperwork. They also can only submit by mail, so there is at least a two-week wait. [Employee #2] assures me that she’ll submit the paperwork. She apologizes for her coworker with an exasperated sigh that tells me this isn’t the first problem [Employee #1] has caused. 

Two weeks pass. I finally get a response from the insurance company in the mail: the extraction is approved, but general anesthesia is not. According to the paperwork, whoever submitted used the wrong code for the new year and it needs to be resubmitted, again. 

It’s now Mid-February and I have been dealing with wisdom tooth pain since October. I can barely eat or sleep because of the pain. 

I call state Medicaid and make a complaint about the way I was treated and how the situation was handled. I am told that my complaint is not valid because I did not receive services from the surgeon. They also will not approve the general anesthesia because I do not have any medical reason for it, i.e., fear of needles, anxiety, etc. To have all four bone-impacted wisdom teeth removed. At one time. No need. At all. 

I find another dentist farther from my area and make the earliest appointment they have. They recommend me to another surgeon, even farther than the first surgeon. I get an appointment with the second surgeon within the week. He apologizes for the first surgeon and assures me that they’ll handle it properly.

It’s now the beginning of March. I get the paperwork from the insurance regarding the new surgeon’s submission; everything’s perfect. I have the surgery on March 27th, half a year after the pain started. It takes longer than expected, as my mouth is small; the surgeon has to take my bottom wisdom teeth in pieces to work around the nerves. I am advised to stay on bed-rest for the next five days. 

Everything works out just fine — months pass and my jaw has healed completely. I end up getting a full-time job and dental insurance — different from state Medicaid — through them. 

Sometime around August, I get a letter in the mail from my insurance, denying payment for an appointment from the very first dentist I saw about a referral to an oral surgeon. 

I call that dentist and have my files transferred as quickly as I can.

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