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HomeMy WebLinkAboutRe: City of Twin Falls - Dental Claim Mike Plane From:Shayne Nope Sent:Wednesday, January 18, 2023 18:24 To:Nelson, Christee Cc:Heather Nope; Price, Toni Subject:Re: City of Twin Falls - Dental Claim Christee, My wife and I feel like we’re taking crazy pills. We’ve gone through this twice with the insurance company and no one seems to be catching on that the reason she had to have the surgery is because she had an extra tooth that doesn’t have a number removed from her mouth. Shayne Sent from my iPhone On Jan 18, 2023, at 1:57 PM, Nelson, Christee <Christee.Nelson@hubinternational.com> wrote: \[EXTERNAL SENDER\] You bet. Christee From: Shayne Nope <snope@tfid.org> Sent: Wednesday, January 18, 2023 1:55 PM To: Nelson, Christee <Christee.Nelson@hubinternational.com>; Heather Nope <heathmcdonald@gmail.com> Cc: Price, Toni <toni.price@hubinternational.com> Subject: \[EXTERNAL\] RE: City of Twin Falls - Dental Claim Thank you. Shayne T. Nope City Attorney CONFIDENTIALITY NOTICE: This e-mail contains confidential information that is protected by the attorney-client and/or work product privilege. It is intended only for the use of the individual(s) named as recipients. If you are not the intended recipient of this e-mail, please notify the sender, and please do not deliver, distribute or copy this e-mail, or disclose its contents or take any action in reliance on the information it contains. From: Nelson, Christee <Christee.Nelson@hubinternational.com> Sent: Wednesday, January 18, 2023 1:42 PM To: Shayne Nope <snope@tfid.org> Cc: Nelson, Christee <Christee.Nelson@hubinternational.com>; Price, Toni 1 <toni.price@hubinternational.com> Subject: RE: City of Twin Falls - Dental Claim \[EXTERNAL SENDER\] Hi Shayne – I spoke with your wife this morning and let her know I would reach out to Delta Dental to get some information on why the claim was denied. The following is the response I received from my contact at Delta Dental. “Nitrous is not a covered benefit on any of our plans and the first claim submitted required additional information to process (missing tooth number). The second claim submitted (nitrous is still not a covered benefit) was denied because based on the documentation provided, our dental consultant could not see a tooth in the position noted on the chart notes or claim itself (tooth number did not match x-rays). If the dental office wants to review and resubmit with a corrected (if an error was made) tooth number, then we can reevaluate and reprocess the claim.” So, it looks like the dental office can submit the claim again with the corrected tooth number to match the x-ray and Delta Dental will review and reprocess the claim. If you have any more questions, please let me know. Thanks, Christee From: Price, Toni <toni.price@hubinternational.com> Sent: Tuesday, January 17, 2023 6:53 PM To: Shayne Nope <snope@tfid.org> Cc: Nelson, Christee <Christee.Nelson@hubinternational.com> Subject: Re: City of Twin Falls - Dental Claim Shayne, your spouse is more than welcome to call me direct. It might make it easier. 208-308-8302z Toni Price Employee Benefits Broker Hub International From: Shayne Nope <snope@tfid.org> Sent: Tuesday, January 17, 2023 5:13:44 PM To: Price, Toni <toni.price@hubinternational.com> Cc: Nelson, Christee <Christee.Nelson@hubinternational.com> Subject: \[EXTERNAL\] Re: City of Twin Falls - Dental Claim I’m trying to get the detail from my spouse as I’m ignorant to the facts. Sent from my iPhone On Jan 17, 2023, at 12:00 PM, Price, Toni <toni.price@hubinternational.com> wrote: 2 \[EXTERNAL SENDER\] Hi Shayne, I wanted to check back regarding the emails below. We look forward to talking to you. Toni L. Price, CIC 208-737-6438 Benefits Consultant / Regional Sales Leader <image001.png> HUB International Mountain States Limited From: Price, Toni <toni.price@hubinternational.com> Sent: Saturday, January 14, 2023 11:16 AM To: Shayne Nope <snope@tfid.org> Subject: Re: Dental Claim Hi Shayne, my schedule is a bit off as I’m out assisting with my mom for health issues. To start with, can you tell me which plan you are enrolled in for dental and what was denied? If you prefer to visit to start with, I’ll ask my account manager, Christee, to call you Tuesday so you don’t have to wait on me. She’ll keep me in the loop of all details. Toni Toni Price Employee Benefits Broker Hub International From: Shayne Nope <snope@tfid.org> Sent: Friday, January 13, 2023 5:10:37 PM To: Price, Toni <toni.price@hubinternational.com> Subject: \[EXTERNAL\] Dental Claim Toni, I had a dental claim denied and wondered if we could schedule some time to discuss any options I might have. Best, 3 <image002.png> <image004.png> Shayne T. Nope <image003.png> City Attorney City of Twin Falls <image005.png> 208.280.8041 <image006.png> 208.735.7374 <image007.png> snope@tfid.org <image008.png> www.tfid.org 203 Main Avenue East Twin Falls, Idaho 83301 CONFIDENTIALITY NOTICE: This e-mail contains confidential information that is protected by the attorney-client and/or work product privilege. It is intended only for the use of the individual(s) named as recipients. If you are not the intended recipient of this e-mail, please notify the sender, and please do not deliver, distribute or copy this e-mail, or disclose its contents or take any action in reliance on the information it contains. 4