Medical Denial
Are you looking to have your wisdom teeth removed or a dental implant-related procedure and been told you have something called medical denial? Medical denial is a lengthy process in which dental insurance companies require your medical insurance to formally deny medical coverage for your dental procedure before your dental insurance will be willing to cover the procedure. As you can see, this can be a complicated process. You will be required to submit a form to your medical insurance company once your treatment has been completed, for them to now “Deny medically” and allow your dental insurance to step in. Once your medical insurance denies that it is not medically necessary, your dental insurance will determine the coverage and pay their specific portion of treatment. This process can be extremely frustrating for the insurance holder and for the dental office. The medical denial process takes anywhere from 6 to 12 months and even once that’s completed, the dental insurance claim has yet to be submitted. As a result, dental offices will typically require the full contracted fee amount set by your insurance upfront before completing treatment. This part of the process can be the most daunting for the insurance holder due to the specific cost. However, the providing dental office will refund the insurance payable amount immediately upon receiving the payment from your insurance provider.
