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Insurance Carrier: Aetna
State: Wyoming

Consumer Complaint:

My daughter had her wisdom teeth pulled in January 2009, my insurance company has requested the xrays. The office manager stated they were waiting on a replicator to make copies of these x rays, she said it would cost me 15.00 and she would call me when they found a replicator. The Dr sent a letter stating that his office would not participate in the insurance games and will not be sending the xrays to the insurance, he stated that there was no way that the insurance experts could possibly read and interpret all the x rays that insurance companies request prior to payment. My insurance company said they can and do read each x-ray and we were charged for the x-ray so they want to see it. This is a $2400.00 dollar bill that would be paid if the Dr would comply with the insurance requests. Can the Dr not comply with this request?

Insurance Expert Answer:

This is NOT an insurance problem -- here Aetna is in the right and entitled to copies of the x-rays before they pay out a large bill.

It is a problem with an unreasonable dentist who is for whatever reason refusing to comply with a reasonable request of the patient. He has no right to do that, and quite frankly it would make me suspicious that perhaps he did unneeded dental work or bad work.

Tell the dentist that you will not pay the bill unless he complies, complain to the local dental society, or sue him in small claims court for the $2400 if you already paid him. Report him to Aetna as well.