Having a dental claim denied by your insurance company can be frustrating — but it doesn’t mean you’re out of options. Many denials can be resolved with the right steps.
Here’s what to do if your dental claim is denied:
📄 1. Review the Explanation of Benefits (EOB)
- Your insurer will provide an EOB that explains:
- What was covered
- What was denied and why
- How much they paid (if anything)
Check for any errors in billing codes, dates, or plan details.
📞 2. Contact Your Insurance Provider
Call your insurer’s customer service line and ask for clarification. Sometimes the issue is simple, like a missing code or paperwork. Have your EOB and dental receipt handy.
🦷 3. Speak to Your Dental Office
We can help review your claim and resubmit it if needed. We may also provide additional documentation or a narrative explaining why the treatment was necessary.
📝 4. Submit an Appeal (If Needed)
If the denial stands, you can file a formal appeal. You may need:
- A letter of appeal (written by you or your dentist)
- Supporting records or X-rays
- A new claim form or updated codes
Follow your insurer’s appeal instructions carefully.
✅ Tip: Get Pre-Authorization Next Time
To avoid surprises, ask for a pre-treatment estimate or pre-approval for higher-cost procedures.
Need Help With a Denied Claim?
We deal with insurance every day and are happy to help you understand your options. Bring in your paperwork — and we’ll walk you through your next steps.