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aflac - dental

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denverb

Member
What is the name of your state? minnesota

i have aflac for dental through my employer. my monthly payment is taken directly out of my check each week. the last few times i went to the dentist my claims were denied because aflac said my policy had lapsed. so i checked with my employer and check my paystubs and every payment had been sent. so my employer talked to the aflac rep. and then they said it looked like my policy had lapsed due to the way that the original rep. had done the book work or something? (it didn't make sense to me). they said to resubmit the claims. so i had the dentist office resubmit it. in the mean time i went to the dentist again. they paid this visit but not the original visit even after we resubmitted it. i went to the dentist for a third time (this was in a 4 week time period). the last visit was denied because of the "lapse of policy". so we called and thought they had things straightened out. they paid the third claim after resubmitting it. but they still haven't paid the first! that was 6 months ago. we've called several times and it's supposed to be getting taken care of. sorry for the length but i thought you would need to know some background. my question is this - when i call them (again) about this first claim is there anything i can "threaten" them with? for examply - "if you don't get this straightened out i'm going to report you to ________ (fill-in-the-blank)" or is there technically nothing they are doing wrong and i just have to waste my time and the dental office's time by calling and nagging them to get stuff paid like they should. they owe me almost $200 for that one visit and now i'm going to be going again in a couple weeks! this is nuts. sorry about the length - does anyone know anything about this??? thanks!
 


Beth3

Senior Member
Who at AFLAC are you speaking to? I'm guessing just a claims analyst/customer service person. When you call back, ask to speak to the manager. Bring him/her up to date on your situation and tell them (nicely!) that if they don't have this mess resolved within two weeks, you'll be contacting your State's Insurance Commission and filing a complaint. Be pleasant but firm. Good luck.
 

denverb

Member
thank you for your reply. my employer's person in charge of the insurance has been doing the calling. i believe she talks to the representative in charge of our company's accounts. she is going to be talking to them again and i told her if that doesn't work then to give me the direct number and i will call them myself. i just talked to the dental office and they said they have submitted this claim 4 times - the last being on dec. 8 and it should have been piad by now! thanks for the advice.
 

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