1
out of 5
POSTED: | BY: Denise
My doggie was having routine dental…
My doggie was having routine dental cleaning. During this procedure, vet called and recommended several teeth to be extracted. This was the 1st occurrence that the vet recommended extraction. We had other dental cleanings before this. Vet would call me back within minutes to provide me with extent of surgery and fees. While waiting for vet, I immediately called ASPCA insurance. The rep was extremely kind. She looked at our plan and said since it was the first time having procedure (extractions) that we have a $250 deductible and then our plan would pay 90% up to $3000.00. Submitted claim for $2300.00. When claim was processed it was for only $1000.00. Called and spoke to rep at ASPCA. ASPCA obtained something called SOAP notes from vet office. ASPCA determined that there was a note in 2018 , 6 years ago, that the doggie had a note of dental build up . tarter on teeth. We provide complete vet check up every 6 months with the same facility. When I called to verify why the difference in reimbursement amounts, 50% vs 90%, I was told the 90% would have only happened in 2018, even though it wasn't medically necessary or advised by vet. Now would only be eligible for one time reimbursement of $1000.00 under continuing care. Somehow this doesn't seem right. Would request further explanation for this reasoning of denial of 90% of fees.
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