I have had a crown denied several times - what do I do?

There are times when a crown is warranted by an insurance company and their consultants just won't see things your way. You've written narratives about the size of the existing amalgam restoration and the fact that there is recurrent decay around the margins, sent in intra-oral photos and x-rays to demonstrate necessity, but the consultants just won't budge.

Your options are partially a function of the state in which you practice. Whenever you receive a denial of benefits, the EOB should always list your appeal options. In some states, after you've exhausted all in-house appeals (including review by their peer review committee) you are entitled to request review by an unbiased third party agency (often at the cost of the insurance company). Other options are the Peer Review Committee of your state ADA component. Check with your state board and dental association for your particular options.

For additional information on practice management and dealing with dental insurance in your office, EMAIL US BY CLICKING HERE

If you would like to start a new subject and discussion, CLICK HERE and give us an idea.

If you would like to COMMENT on this topic, click on the "comment" link below.

If you would like to email this post, click on the email icon below.

If you would like to subscribe to the RSS feed and be notified whenever this Blog is updated, click on the XML icon below for more information.