Dental Insurance

undefinedWhat is the name of your state? Oklahoma

I took my son to the dentist a few months ago. The dentist checked his teeth and recommended that he have sealants. I told him that he had sealants put in one year ago. He said that they had worn off and that he needed them again. I asked if the procedure was covered by insurance because I wanted to make sure that it was covered. I was told that it was a covered procedure. I just received a bill three months later for the full amount for the sealants. I called the dentist's office and the billing department said that they filed my insurance and it was denied because the we had already maxed our benefits for that procedure. I called the insurance company and that procedure is only covered once every three years. My question is: Is the dentist's office responsible for finding out the limitations BEFORE the procedure is done so that I can make the choice whether or not I want to pay out of pocket for it? I specifically asked before the procedure was done because I did not want to have it done if I was going to have to pay for it.

[cbg]

No, it is YOUR responsibility, not that of the dentist's office, to find out what coverage is available.