Dental plan: Call your columnist CASEY: Collinsville man finally gets covered dental appointment – by calling newspaper columnist

A couple weeks back this column related a dental quagmire Andy Parker's been caught in since January. Unsuccessfully, the Collinsville senior citizen has been trying to get an appointment for a routine oral checkup, under his Medicare Advantage HMO plan.

That has not gone swell.

This is the latest chapter in a nine-month saga that Parker said has left him feeling like he's a character in the Hollywood comedy "Groundhog Day." Fortunately, it appears there's a resolution.

Parker, 71, has been a Medicare Advantage subscriber since he turned 65. Initially he signed up for a preferred provider Medicare Advantage plan (PPO) offered by Humana. He said he had no problems accessing routine dental care under that.

But last year, during Medicare's open enrollment, Parker changed to a Health Maintenance plan (HMO) offered by Sentara, because it offered a $100 grocery coupon. That plan's dental care occurs within a network of dentists, DentaQuest, which is owned by insurance company Sun Life.

Working from a list of DentaQuest dentists, Parker has made dental appointments in Danville, Collinsville and Roanoke. But closer to the appointment, each office contacted Parker and informed him it does not accept his Sentara HMO Medicare Advantage insurance. So he canceled those appointments.

Meanwhile, Sentara and DentaQuest kept insisting to Parker those offices would accept his appointment. At one point, a case manager for Sentara told him it would work if he made his appointment in person, rather than over the phone.

But that didn't work either. One office to which he drove to make an appointment told Parker they didn't accept his insurance.

After publication of the Sept. 5 column, a DentaQuest spokeswoman informed me that Parker had an appointment at Aspen Dental in Roanoke for Sept. 26.

That was news to Parker. He had made no such appointment.

It turned out that DentaQuest made it for Parker, after he filed a grievance with Sentara that no dental practice on its list would accept his Sentara Medicare Advantage insurance.

Then last week, Parker received a letter that listed both Sentara, in Virginia Beach, and DentaQuest, in Wisconsin, on its letterhead. It alerted Parker to the Sept. 26 appointment at Aspen Dental in Roanoke.

After confirming the appointment only with Aspen Dental, Parker called DentaQuest customer service and spoke to a female rep whose name he didn't get. But he praised her attitude and her helpfulness.

Parker asked her to conference-call Aspen Dental in Roanoke, with Parker on the line, to see if the practice would confirm acceptance of his insurance for the Sept. 26 appointment. The rep agreed.

Together, they spent 51 minutes on the three-way call with Aspen Dental. By the end of that, neither Parker nor the rep could get any assurance his appointment at Aspen Dental would be covered. That was Sept. 10.

"For whatever reason, no one at the Aspen office will (confirm coverage) on the phone," Parker told me.

Maya Linson, a spokeswoman for DentaQuest, didn't dispute Parker's account of what happened on the nearly hourlong call.

"He is not incorrect," Linson told me. She said she would continue trying to get Parker confirmation from the practice.

Then, this past Tuesday, Parker got a voicemail message from a woman who identified herself as Cynthia Gray with Aspen Dental.

It was pretty muddled, but when Parker called her back she confirmed Parker would be covered at Aspen Dental for the Sept. 26 appointment.

Because Parker has heard that before, and later been informed otherwise, he asked Gray for written confirmation - a simple email. She said she would send that, he added.

Wednesday, Linson (with DentaQuest) sent me an email, which stated: "As far as I understand, Mr. Parker now has verbal and email confirmation that Aspen Dental Roanoke accepts his Sentara Medicare Advantage plan."

But Parker had not received the promised confirmation email from Aspen Dental. Linson expressed frustration when I informed her of that. She said she would keep trying.

More or less, it seemed like the same rigmarole Parker's gone through repeatedly, since January, not only with Aspen Dental but with other dental providers on DentaQuest's provider list.

Repeating the same steps over and over, fruitlessly, while expecting a different outcome is "the definition of insanity," Parker said.

Aspen Dental is a national company that spans 46 states and has 21 offices in Virginia. Its headquarters is in Syracuse, New York. Wednesday, I spent significant time trying to contact a corporate spokesperson by phone and email. I got no response before deadline.

But also yesterday, and just before 3 p.m., Maya Linson with DentaQuest sent me a copy of the email Cynthia Gray with Aspen Dental had sent Parker.

The date and time on Gray's email was Wednesday at 2:51 p.m. It identified Gray as Aspen Dental's regional manager for central Virginia.

"Dear Mr. Parker," it began, "Thank you for taking the time to talk with me yesterday regarding your insurance. I wanted to let you know that we are in network with your insurance company. We have confirmed your benefits breakdown and coverage."

Parker says he will make that Sept. 26 appointment. And he'll take Gray's email with him, just in case.

He said that over the past nine months, he's dealt with a nurse-case manager at Sentara, multiple managers of at least four different dental practices, and customer service reps with DentaQuest.

But it took a phone call to a newspaper columnist in Roanoke for Parker to get assurance that his dental appointment would be covered under his Medicare Advantage plan.

"Without your involvement, I don't think I'd be getting my teeth cleaned," Parker told me.

Dan Casey (540) [email protected]@dancaseysblog