Grandma's old dentures were so bad that she couldn't eat so the nursing home got a dentist in to examine her & make new ones. The nursing home was supposed to file with her insurance companies but somehow messed that up & refuse to do anything about it now. Apparently they havent even tried to file with Medicare either and the dentist has come after my mom for the money ( she is gma's proxy), telling her that if she doesn't pay, they'll call APS ! Please give me some direction, mom is SO stressed about this !
Does Grandma have assets?
My mom's general dental care was paid for by private dental insurance. If she had needed new dentures, she would have paid for them out of her funds. We declined to have new dentures made.
Did mom sign as responsible party? Just because she is poa does NOT make her responsible for gma's bills.
For hearing it is necessary to use a specified provider. No way is the whole cost covered for everything but it helps some.
Unless Mom signed as the responsible party for Gmas dentures she should not be responsible. If Gmas funds are all being used for her care and the NH authorized the dental procedures it could be the NH is actually responsible for the costs.
I do not see any action that APS could take against Mom. She is not facilitating any abuse of Gma.
I think this is just debt collecters trying to put the frighteners on Mom to try .and get money
From Medicare dot gov
Dental services
How often is it covered?
Medicare doesn't cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you're in a hospital. Part A can pay for if you need to have emergency or complicated dental procedures, even though the dental care isn't covered.
My parents had private dental insurance on and off for 30 years after my Dad retired from work. They were so surprised that Medicare didn't pay for dental care. And here my Mom had upper and lower plates, of which she was always breaking them as she never kept the plates in long enough daily to get use to them.... [sigh].
Now if Gma is private pay for her room and has dental, the insurance may pay partial and Grandma pays the rest. The home cannot help you with this. Their responsibility was to give the dentist insurance info and he was to do the billing and predetermination with the insurance. Since ur getting harrassed I am assuming the bill has been turned over to a collection agency. You need to call the dentists office and ask for billing dept. You need to find out from billing what insurance co. they sent the charges to. Like I said, if GMa Medicaid then you owe the dentist nothing. If you have dental make sure they went thru them. If Gma has dental, ask if a preditermination of cost was done before work. Most dental insurance require this and will either penalize or not pay the claim. If this happened then the dentist is up the creek with no paddle. You then have to determine what part of the bill insurance would have covered and you just pay what u would have originally. You r not responsible for his penalty. Once you get this straightened out, ask the billing department who u pay, them or the collection agency once its all straightened around.
Lets say Gma is on Medicaid, she is because there is no money. When you get a call about payment determine first if its a collection agency. If they say yes, then explain Gma is on Medicaid and because of this she has no money. And, as her family you are not responsible for her debts. Also, you will be talking to the dentist office office concerning the bill and they (the collection co.)is not to call you again. If they do you will report them for unfair practices. There are laws in place for Collection agencies and harrassment is a no no. If I have totally confused you, call your local Officevof Aging. They may have someone who can take you thru the process. Worst thing that could happen is Gma's credit be effected. At this point, who cares. Did Mom sign anything OKing the procedure? Make sure she didn't sign anything saying shecwould be responsible for payment.
The dentist asked me if I wanted the dentures. I said "Leave them here and teach kids how to properly brush their teeth". So I actually got to take the $800 as a charitable contribution. :)
I don't think Medicare covers dental work. Not sure, probably should look into this, retirement looms.