Dentists - We Need Your Help!

At the weekly consultant phone-in our cross-payor team discusses issues they see on a regular basis. This week the topic was: Please! If a patient's dental plan has an alternate benefit (which a large majority do) and you are replacing a missing tooth with a fixed bridge, PLEASE submit full arch radiographs!

Consultants need to review the entire arch to determine if other teeth are missing and the alternate benefit applies. Some dentists try to hide the fact that there are other teeth missing by only submitting the side being treated. Consultants require both sides and holding back will usually just delay your claim or pre-determination while this information is requested.

More on the alternate benefit provision on a later post.

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