As a direct result of challenging denials/refusals of my available, clearly contracted, prepaid and professionally recommended HP dental services, I have been further victimized by the lack of due process and incompetence prompted by Paul Amundson (Como Clinic dentist) and sycophantic group speak by Morgan Kruse (Senior Consultant for Member Rights and Benefits).
My HP dental services contract states, “When cleanings are received by a HealthPartners Dental Clinic, when dentally necessary and per the dentist’s recommendations, the member is not subject to cleaning limitations and would be covered up to the annual maximum benefit listed above.”
After my HP recommended and prescribed quarterly periodontal cleanings by HP Como Clinic Dental Hygienist Mary Swenson (29 June 2018), I asked Amundson, “What about my x-rays?” In an angry, loud and threatening response, Amundson yelled, “I told you that you can have only one x-ray every two years.” I said, “That’s not what my contract says and my last x-rays were more than two years ago.” Amundson asked, “Are you threatening me?” I said, “No, I’m ridiculing you?” Amundson replied, “I don’t like to be ridiculed” then he called security.
Any supposed professional claiming a modicum of intellect and concern for details and facts through rational behavior and psychological health probably would investigate unknowns first. A mature and rational Amundson could have simply called HP’s corporate level membership authorities for details of Cooper’s HP dental contract.
According to Kruse (letter copy enclosed), “We have learned that there was a breakdown in trust and confidence between you and HealthPartners Dental Group. After discussing this, the staff has determined that it would be in the best interest of both you and HealthPartners Dental Group to transfer your care to another care system.” It was HP’s “breakdown in trust and confidence” that denied/refused contracted prepaid x-rays for Cooper.
Question: Exactly what was denied Cooper by HP dentist Paul Amundson? Answer: Two more of the quarterly periodontal cleaning as prescribed and previously delivered by HP dentists since 2010, a Bitewing x-ray and an overdue panoramic x-ray.
I have excluded numerous people and positions in the Health Partners (HP) management chain of command because: (1) I have been denied due process, services based on clearly stated contractual agreements; and (2) a genuinely objective complaint hearing. At very least, HP’s right hand fails to coordinate with HP’s left hand by carefully ignoring details and facts resulting from incomplete and/or incompetent information gathering.
(A) My July premium payment ($34.36) was mailed to and received at HP’s corporate P.O. Box 9136 on or before 31 June 2018, in the form of a Wells Fargo personal money order (serial number 7308624366); (B) Since I recently received a bill for $68.72, evidently I was not credited for July’s correct/proper/timely premium payment submission; and (C) as a result of being absurdly and prejudicially removed (thrown out) of HP’s dental services minus due process and factual information, why would I get a bill/notice/statement for $68.72 (premiums due for July and August 2018)? Yes, there was a “breakdown in trust and confidence.” I’m the undeserving victim.