Verwon Says:
Denture Supplier Not Sending In For A Prior Approval For 15 Days After Appointmet
Updated
Mark Says:
Is there a time frame that Dentist or dentures office have to send in a prior approval to Medicaid claim. I went to have new dentures sense mine broke, I went to denture place and they waited 15 days before they sent Medicaid information for a prior approval ( PA). I am a diabetic and cant eat right and I told them I was a diabetic when I went in to be seen. thaks for any help you may give me.
1 Reply
1
Hello, Mark! How are you?
I am not familiar with Medicaid regulations, but going by the current government regulations regarding dentures, I doubt that they did anything wrong.
The way things are right now, regardless of your medical condition, dentures are not considered essential to your health. Our government considers them to just be cosmetic, because you can still eat without them, it may be a liquid diet with supplements and such, but it is possible. That's why in many states, low-income programs don't even cover them.
If you had bad teeth that could put your health in further danger, due to infections, they will pay to have them removed, but they don't consider dentures to be medically necessary.
I have full dentures myself, so I know that this information sucks and I am very sorry about that.
The best suggestion I can make is that if you still have your old ones, check into getting them repaired inexpensively somewhere, in the meantime. There are many places that will do same day repairs for you, while you wait and in many cases it's less than $200 to do both dentures.
Is there anything else I can help with?
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