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Periodic Contributor

Medicare Advantage Payment Delay

I had a routine dental appointment Dec. 6, with a new dentist since my previous dentist had retired. Both were or are MA plan providers.

 

The dentist required me to pay, with a refund due when MA pays. They submitted the claim, and a month or so later when MA had not paid, resubmitted the claim per MA request. 

 

Four months after the service, the claim has still not been paid for unknown reasons. The MA website states that the claim is under review. The dentist office call to the plan received an answer that payment would be made in 30 days, with no explanation for the delay. My call to the MA plan received an answer parroting the website (under review) with no explanation for the delay. A complaint to the Idaho Dept of Insurance received an answer that they did not see a problem. I filed a grievance with the MA plan with no response yet except for acknowledgement of receipt.

 

I am thinking I need a different dentist. Any other suggestions on the overall problem?

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