DentaQuest

Both of my kids have dentaquest medicaid and both have been denied medical treatment requested by their dentis. My daughter and son were given the same canned response and both denied the same day the claims were submitted I am beyond angry that the insurance decided that the care the dentist recommends is not medically necessary. Today I received a notice that it’s not medically necessary for my son to have braces. I spoke with a representative today 09/06/2022 who stated that she would not argue with me and that the only way dentaquest covers braces is if he could not chew. Please note I have braces and for the same reason they were recommend for my son overbite and crowding. She states that he was denied for that as well. And he a not medically necessary from what she is reading. Also the attached notices show he was first denied as not medically necessary, now it’s a different reason. I also received a notice for a grievance in finding a dentist. I never filed a complaint for not being able to find a dentist. I honestly feel no one reviews the case or request as he was denied the same day claim was submitted. Also my daughter has the same verbiage verbatim in her letter for something completed different. When asked was she viewing the records, pictures or x-rays representative became angry and stated she is not going to argue with me!

My son has been waiting months to find a dentist that can sedate my 17 year old disabled son for his extensive dental work. We have been given the run around and after more that 10 documented hours of phone calls, dead ends and a possible mental breakdown on my part my son was hospitalized due to aggression caused by anxiety as a direct result of the massive amount of pain he is in 100% of the time. Our only option is to pay almost $900 put of pocket to have his work done and let me tell you, for a family with a disabled child, this is not reasonable or even achievable. I have been on hold for 20 minutes again as I write this because I refuse to let the call end without a result today! I am convinced that denta quest does not care about the children it is supposed to support and I would like to file a formal law suit for the pain and suffering my son is enduring due to their negligence to provide efficient service of his covered needs that he has a right to receive according to the law. Enough is enough!