Guardian Dental Insurance Billed me, telling me I used an "out-of network" provider when I used an "in-network" provider. Fraud. Spokane Washington
I was mailed a bill for $349.20 with a note at the bottom stating that, "Benefits are based on the use of a non-contracted dentist.". I called Guardian to ask for an explanation, as I know I did my research on their website and sought out an in-network dentist. The rep was not able to assist, so I asked to speak with a supervisor. "Jess" got on the phone and made NO attempt to investigate or to research/resolve the situation. She told me that if I "disputed the claim, it will be denied". Well, that is not her role in the company, claim disputes do not go to her, they go to a different department. "Jess" tried to tell me that I misused their website.
Once I got off the phone with her, I got back on Guardian's website and took sreenshots of the dentisit that I used showing that he IS in their network. I called Guardian back and asked to have a manager call me. Peggy called me and she was able to see that the dentist I used was currently in-network and was on the date of service. Peggy said that the dentist office needed to submit a new claim with the physical address where the treatment was done. The claim the dentisit office submitted had their home office address on it. It was like these people don't know who's in their own network! Peggy confirmed that "Jess" was incorrect when she told me that if I disputed the claim that it would be denied, as that is not her job. I told Peggy that I want to file a formal complaint against "Jess"; Peggy put me in touch with her manager, JAN BUSHY (direct line: 509-468-6394). Jan told me that she doesn't have a "Jess" on the management team and that it would take her a few days to go back and listen to all of the calls. Once that was done, Jan contacted me and told me that "Jess" is really Beth.
I was lied to by a member of Guardian's management team and that is FRAUD. Management is supposed to be held to a higher standard. Jan said that Beth is new to her management role but that she has been "coached", therefore, filing a formal complaint would do no good. Haven't I heard that before? This woman was promoted to management yet she doesn't know her job duties and responsibilities? WHAT? I don't want this to happen to others. To me, $349.20 is a lot of money. I saw one other report on Rip Off Report for Guardian Dental Insurance. I am now going to file a claim with the State Insurance Regulator - Consumer Protection Department. I hope this story helps someone.