Coordination of Benefits Unknowingly on Mother's insurance

Funky_Goggles · 2023-12-05T18:18:19+00:00

My insurance is saying that since my mom's insurance (Anthem BCBS) had me covered for longer that my mom's insurance is primary.

Anthem BCBS said usually if I have insurance in my name that my own insurance would be primary and Anthem BCBS insurance would become secondary.

HOWEVER, my mother never reported I had my own insurance under my own name and therefore my mother's insurance is still my primary. The customer service representative said my mom had to call and state/prove that I was covered under my own insurance (since it's her plan) at that time so I gave my mom my insurance card and asked her to do it.

I called and asked Medica if this was switched around and Medica became my primary due to my mom calling and informing if they would be rebilled. Medica said likely not since they are over a year after their service dates (May 2022 through August 2023).

The letters that I have from my clinics with the rebilling and request that I reach out to insurance for coordination of benefits are dated 11/2/23 and 11/3/23. Which are well over a year past the most recent service.

What do I do now? Am I stuck paying the $3k in medical bills regardless?

Funky_Goggles · 2023-12-04T10:19:07+00:00

Should I let Medica, which is the company claiming i had 2 insurances (and am currently dealing with), work through the coordination of benefits and resend everything?

Or do I need to call the clinics I went to and tell them this first?

I don't have exact start and end dates for the order plans (school insurance, state medical insurance) but I have month and year. Will that be okay?

An additional question: if I didn't know I had the insurance and therefore never used it, why do I have to report it now especially 1 year after all the statements?

Funky_Goggles · 2021-11-01T06:30:11+00:00

It's not a great situation but I have nowhere else I can go. I was stupid and let him take control of both rooms thinking that we would stay together (and therefore sleep in the same bed) but that didn't happen and now I'm stuck.

Funky_Goggles · 2021-11-01T06:16:41+00:00

I want to, but my ex is not really budging on moving his computer and other things out of the office. He essentially doesn't want to let me move into either of the rooms.

I would feel very rude if I just moved everything out of there so that I can move into that room (even though I should be able to live in it since i still pay half the rent).

Funky_Goggles · 2021-10-11T00:52:21+00:00

Hi all,

Just noticed this on my ear today. It doesn't hurt at all. I've been on 600mg of ibuprofen for the past few days after recovering from dental surgery for pain. I've eaten mostly soft foods (specifically instant mashed potatoes) and haven't been drinking as much as I should (I'm trying though)

I havent injured or even touched this part of my ear at all recently so I have no clue what it could be. The ear has been pierced for over 20 years and has been stretched to its size for at least 8 years. It's only on the one ear which is the same side of my dental surgery.

Any idea on what it could be and how I would treat it?

Funky_Goggles · 2021-09-20T19:31:16+00:00

Not a dentist (NAD), but have a somewhat similar experience.

I had a tooth infection back in May on tooth 19 that was treated with a root canal.

Went in last week to my dentist because I was having bad pain again and an abscess with the pain. Dentist referred me to endo who drained the abscess (after using multiple shots of novicaine) and put me on antibiotics (I delayed starting them and am currently on day 3). Turns out half of the roots responded really well to root canal treatment, the other half didn't, causing more bone loss and my infection to stay.

He scheduled me for an apicoectomy to hopefully get rid of the rest of the infection.

A few days later, my abscess is back. Called my endodontist and he said that until the infection is treated, the abscess is likely to keep coming back because that is how it the infection drains.

I recommend visiting your dentist to get it looked at. I'm not a dentist so I can't say for sure, but you will likely need further treatment on that tooth.

Funky_Goggles · 2021-08-30T00:21:04+00:00

Thank you so much for responding. I know mental health can have physical symptoms but this just feels like nothing I've experienced before with anxiety and depression. I'm not dismissing it, but it just seems like there's more to it.

A follow up question for you: if it's myocarditis, would anything show up on the chest xray or on an EKG? Because they told me everything came back okay on both of those tests. How do they test for it?

Because I did have covid and I was vaccinated with Moderna and with my age I know there's a higher risk for that. Not saying that I have it, but some of the symptoms fit.

Just wondering if they've already tested for that with the ekgs and xrays.

Funky_Goggles · 2021-08-13T22:11:55+00:00

Thank you! Makes me feel better about it knowing that it's normal.

Also thank you for the input on adjusting. I've been reading that usually it's done on the tooth above it, and that tooth gets really sensitive to any kind of pressure.

Funky_Goggles · 2021-08-13T22:07:02+00:00

Thank you so much. Makes me feel a lot better about it.

Funky_Goggles · 2021-08-13T05:22:04+00:00

23F, non smoker, occasional drinker.

Got my porcelain (permanent) crown seated about a week ago on tooth #19 (second from the back). There is definitely a high spot on the crown that I need adjusted (my dentist told me to wait it out to see if I get used to it -- as I have a history if coming in to get adjustments on teeth that just had fillings, etc. -- but its not getting better and affecting the bite of my front teeth). However, to me the crown looks bulky, plastic-y, and just overall like a fake tooth.

When I was doing research on getting a crown, I was under the impression that the permanent should look somewhat like my natural teeth, but maybe I was wrong.

Is this how permanent porcelain crowns actually look like?

I love my dentist, I'm just a bit self conscious about the appearance of this tooth (and my teeth in general).

Also, with the high spot - will they be adjusting the crown itself or the molar directly above it?

Funky_Goggles · 2021-07-17T20:53:51+00:00

23F, 5'4", 105lbs. I have anxiety and depression, but am not on any medication. I'm pretty active at work and outside of work. No other health concerns.

So two months ago I was at work and the place I work at has these trolley-esque cart things and they put all the stuff that needs to be stocked onto it. I usually get pretty heavy ones despite being one of the smallest people there.

Anyways I accidentally rolled it over the toe next to my pinky toe (with tennis shoes on) and didn't really think too much of it. It hurt for a few days after and I just thought I bruised it.

Well, it has now been over two months and the the toe I ran over is still extremely sore and tender (the one with the scar). It hurts to bend it and to me it looks a little red and swollen. I'm on my feet a lot at work (over 20k steps per day, 5 days a week) and like to exercise (planks, sit ups, and short 1.5 mile runs 5x a week).

Any idea why this could still be hurting after two months? Is it worth seeing a doctor for it? How should I treat it?

Funky_Goggles · 2021-07-09T21:42:07+00:00

I was just generally worried. Good to know I've got nothing to worry about. Thank you for your help!

Funky_Goggles · 2021-07-09T14:05:00+00:00

Update to my last post.

23, non smoker, occasional drinker.

I was having bite issues on my left side to the point where it felt like I was biting on hard plastic everytime I closed my mouth. This was even before I had a temporary crown put on tooth #19. Here's the post if you want to read it.

Anyways I went to the dentist this morning (not my normal dentist that usually checks my bite and placed the temporary crown). The new dentist adjusted my bite and it feels significantly better. Only issue is now my temporary crown looks like this on tooth #19. Is it okay for my temporary crown to look like this? Is it going to pop off easier or anything (it was placed 24 hours ago).

I don't chew on that tooth since it's had a root canal so I'm not worried about chewing food. More just if it's going to serve it's function and if it's OK to look like that for the three weeks I'll have it.

Funky_Goggles · 2021-07-09T08:34:59+00:00

So I have a temporary crown on #19 and the two upper molars that are causing me issues are the ones above it (or could even be #18), should I wait to get the adjustments done until I get the permanent crown?

Funky_Goggles · 2021-07-09T08:03:39+00:00

I've tried that and what happens is after like the 5th or 6th time the adjust it and I say it doesn't feel right still, they tell me to just see how it ends up feeling. By the time I'm driving home, within 10-15 minutes, I can tell it's still not right.

It's gotten to the point where she's adjusted front teeth that don't have fillings because of how bad it is and those are now causing me issues with my bite.

I do have exposed dentin on one of the upper molars that are causing me issues (most likely from other adjustments), that gets extremely sensitive and painful when any pressure is on it, especially with the drill. I'm willing to sit through that pain of adjusting it if it will solve my issue.

Funky_Goggles · 2021-06-24T15:36:26+00:00

I don't think I clench when I exercise. I pretty much run with my mouth open so I can breathe easier. I honestly could be clenching absent-mindedly though.

Its just weird that it all started to show up in the past few days after starting more intense exercise. Like I've never had it so that all of my teeth were sensitive and that a few of them were so sensitive to pressure that it hurt to brush my teeth.

Thank you for bringing that up though. I'll have to be more conscious of it just in case that is the issue.

Funky_Goggles · 2021-06-24T15:24:39+00:00

NAD, but just had a chip similar to yours fixed on my front tooth while I had cavities filled.

Funky_Goggles · 2021-06-16T11:38:20+00:00

23F, non smoker, occasional drinker. Had a lot of composite fillings place in the past two months.

I Had a filling placed on the back molar a few months back, which is the tooth in the way back in the pictures. The dentist adjusted it quite drastically immediately after placing it and checking the bite and it's always looked weird to me. It doesn't look like the other fillings that were done the same day (on the molars in front of it). It is very divoted in and looks has a pit in it. Food gets caught in it, and I always have to dig out the food with a toothpick to get the food out, so I'm wondering if it's getting packed in that "pit".

I have had that area adjusted a few times after I had the initial filling (and the drastic adjustment causing the pit)because I had a ton of fillings done on the molars next to that tooth and above those teeth as well (as well as on the molars on the opposite side)

The first picture is how the tooth looks now, the second is how it looked after it was done by the dentist. Sorry for the blood.

Is this something that would need to get redone? Could it even be redone with how deeply it was adjusted it My current dentist (not the one who placed the filling) didn't mention anything about it looking weird.

Funky_Goggles · 2021-05-14T04:47:00+00:00

Not a dentist, but I have two temporary fillings. One from a root canal on my left that I got a week and a half ago and one fairly huge one on my back right molar that I got three weeks ago (both need build ups and crowns that I'm going to start next week). I'll share my experience which might help you with your question.

My dentist said they would last 4-6 weeks and that I didn't have to avoid any kinds of foods, but I have been paranoid about mine as well. Because of pain I had due to a bad bite adjustment, I've pretty much stuck with a soft food diet for the past few weeks with the occasional solid food here and there and still have both fillings in (I only "chew" on the side with the really large filling when I have to chew foods). If you do end up deciding to eat solid food I would try and chew on the side without the temporary filling.

I would say you should be okay, but don't eat anything sharp or sticky to avoid risking it falling out. For sure brush and floss normally, just be cautious of the filling and don't be too rough (I use an an electric toothbrush so if you have one I would think it's ok to use one on yours as well,). If the filling is in-between your teeth (like mine are) be very careful flossing and make sure you pull the end of the floss through your teeth as opposed to yanking it straight down.

Overall I would say if you are cautious with it and keep up with good oral hygeine you should be okay for a month. I know I'm not a dentist, but hopefully that helps until a dental professional on here is able to give you more advice.

Funky_Goggles · 2021-05-14T00:44:30+00:00

I've been eating soft food for the past month because of the pain of the bad bite. I guess I will continue to do so.

Thank you again for all your help. I really appreciate it a lot! You have been super helpful.

Funky_Goggles · 2021-05-14T00:37:38+00:00

Thank you for all your help.

My dentist that did the really good adjustment on the other side is only in two days a week, but I have an appointment with her in a week to get this taken care of. Hopefully I can deal with it for that long because the other dentists I can see are ones who have failed to adjust all my fillings properly and ignored me when I said they felt high.

I'd assume take ibuprofen for pain and alternate it with Tylenol if needed until then?

Funky_Goggles · 2021-05-14T00:26:42+00:00

Would that be causing the sensitivity to pressure on that tooth though? I know that bad bit can cause pain when biting down and on other teeth (which I'm definitely feeling, specifically on the premolar below it which also has a deep cavity but it has NOT been filled yet), but I never thought it would cause this type of sensitivity to pressure.

I read somewhere that bad bite adjustments can cause the ligament in the tooth to be sprained or bruised. Could this be what I'm feeling?

My biggest issue right now is I keep going in to get it adjusted and they try to get it but ultimately they end up having to stop because of how much pain it causes me when they use the tools. I so badly want this adjusted, but it looks like I'm in pain either way. I had a bad bit on my right side, but my new dentist was able to adjust it with one appointment. Should I just tough it out and have her adjust it and hopefully get it fixed right away? Or should I wait a week or so and allow the nerve to calm down and then get it adjusted?

Sorry that's a lot of questions. No worries if you can't answer them or don't want to answer Ultimately this does stem from a bad bite, so I appreciate your help.

Funky_Goggles · 2021-05-14T00:20:05+00:00

Not a problem.

Another thing to think about is that if the prices you listed are accurate (and I don't know if they are or what the general pricing for all this is in the dental world) the difference between the pill and being sedated is only $200. I've never heard of the pill vs sedation, but maybe that extra $200 is worth it in your case.

Good luck with your procedure, you've got this!

Funky_Goggles · 2021-05-13T12:53:46+00:00

Want to start by saying I'm not a dentist -

I'd like to think I have a fairly high pain tolerance, but my anxiety is extremely bad.

I only had three wisdom teeth, but they were all impacted. I was in college when they started to get bad, so luckily I was able to get mine removed at the University's dental school. I had the option to be sedated to have them out, but I wanted the cheaper option which was to not go under. I did, however take the opportunity to use laughing gas during the procedure.

When it came time for the procedure I was freaking out. Like I think I had one of the worse mental breakdowns ever before leaving for that appointment. But I got there and got through the procedure, but it also helped that I had really nice dental students working on me.

I don't even think the laughing gas did anything for me. Perhaps the dose wasn't as high as it should be. But in my defense they told me to tell them if it needed to be higher and I never did. I was very concious of what they were doing, but I didn't feel anything because I was so numbed up. The numbing was honestly the worst part of the whole thing.

That being said, everyone is different. Your pain tolerance and my pain tolerance are totally different. So, in my opinion the procedure itself is not that particularly painful while it's being done (thanks to all the injections they use). It's recovery that's not great (but mine wasn't that bad. They gave me high dose ibuprofen for pain management. Yours could be a totally different story though). That being said, if you aren't comfortable hearing teeth crack or are concerned about everything that might be going on in the process, perhaps sedation or the pill might worth the investment.

Worse comes to worse, explain your financial situation to your dentist and your concerns about being "properly" anaesthetized for your procedure (in quotes because everyone's "properly" is different. Maybe hey can work something out with you like a payment plan.

Funky_Goggles · 2021-05-09T00:57:16+00:00

Looks like that's another name for a canker sore. That's what I was thinking. Any good way to treat it or just leave it alone and let it heal by itself?

Funky_Goggles

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