Background: I did a dental procedure during the waiting period of a new dental plan. My dentist contest that contracted prices do not apply during this period despite the fact that the insurance company gave a letter explicitly saying otherwise.
The dentist interpret following definition of covered services in Illinois SB 3242 to say that procedures during waiting period are considered as uncovered services:
"Covered services" means dental care services for which a reimbursement is available under an enrollee's plan contract, or for which a reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods,annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation.
Is this interpretation correct? If I understand correctly, above means the opposite and the dentist is still bound by the prices contracted with the insurance company. (Pardon if this is more of a English language question than a Law question.)