3OYS: Getting dental insurance co. to pay bill is like 'pulling teeth'

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By Christina O'Haver By Christina O'Haver

MESA, Ariz. -- Amy Muniz is an avid reader, but because she's unemployed, she's giving up some of the things she enjoys to help make ends meet.

"This is a $30 book and it was well worth it," Muniz said, as she held up one of her favorite novels. "I'm trying to sell stuff, sell eBooks on Amazon in my spare time."

Muniz said if she's not reading or selling books, she's spending much of her time on the phone battling the Delta Dental insurance company.

"They want to charge me $940," Muniz told 3 On Your Side.
 
That $940 is difficult for Muniz to pay since she is unemployed, but she shouldn't have to pay it because it's Delta Dental's portion to cover.

Muniz said the problem started last year when her dentist told her that her wisdom teeth needed to be pulled.

The good news is, removing wisdom teeth was covered under her Delta Dental policy in 2013. However, Muniz said that after the procedure was completed, Delta Dental denied the claim and stuck her with the $940 bill.

"Oh yeah, I've been getting the runaround," Muniz said.

Turns out, her teeth were pulled in 2013 when extracting wisdom teeth was, in fact, covered by Delta Dental. However, the claim was submitted the following year, when the procedure was no longer covered.

Muniz said getting the insurance company to understand it's looking at the wrong year for coverage has been exhausting.

"So, it could be as simple as someone just not bothering to look at the year," she said.

3 On Your Side got involved, and Delta Dental immediately looked into the matter. After reviewing the case, Delta Dental quickly processed the claim correctly, meaning the dentist was paid and Muniz was off the hook for that bill.

Muniz said she's glad to the matter is over and credits 3 On Your Side for putting it to rest.

"Delta Dental is going to pay the claim, and I'm real glad that this isn't going to go to court or wind up on my credit or something worse than that," she said. "Thank you Gary Harper!"

By the way, Delta Dental said in an email to 3 On Your Side that it was in the process of paying the claim before we got involved. However, Muniz said she's been asking the insurance company for months to resolve the matter and things went nowhere until 3 On Your Side stepped in.