Mark Grucella DDS & James D. George DDS

I am rejecting this response because: My Medicare Advantage policy with Anthem Blue Cross Blue Shield covers cleaning and an exam. It does not cover x-rays. There are no restrictions in my Evidence of Coverage book which says I must get x-rays first before any other covered work is done. If there is a restriction it certainly ought to be conveyed from the provider to the insurer and then to the insured - ME. At the time of the incident I told the dentist office I was willing to forget the exam and just do the cleaning. They refused. The Standard of Statutes they claim to follow means nothing to me. And I do not feel I am required to follow, or agree, with them. I just want the benefit due me and which they have agreed with Anthem to provide.

[redacted] was last seen by our practice on November 12, 2013.  X-rays are in excess of 3 years and no longer diagnostic for correct standard and quality of of care. Insurance does not dictate care for any patient and due to the length of time that has passed since patient being last seen...

on November 12, 2013, the Doctor is correct in requesting recent X-rays for a thorough and complete diagnosis of the patient's dental condition. Patient is not compliant due to being outside the two years standard of statutes per the Ohio State Dental Board.  Please do not hesitate to contact our office for further assistance in this matter.Thank you,Paul S[redacted]Business ManagerDr. Grucella & Dr. [redacted], Family Dental Team, Inc.