I have two claims for crowns that have been denied – two separate patients, one insured with MetLife, the other Principal. I have been through one appeal with MetLife and two appeals with Principal. I have never had claims denied for lack of necessity. They were necessary and obviously I did not provide the correct documentation/narrative. I would appreciate any help getting insurance benefits for these two patients. Thank you, Beverly Knight

I have two claims for crowns that have been denied – two separate patients, one insured with MetLife, the other Principal. I have been through one appeal with MetLife and two appeals with Principal. I have never had claims denied for lack of necessity. They were necessary and obviously I did not provide the correct documentation/narrative. I would appreciate any help getting insurance benefits for these two patients. Thank you, Beverly Knight

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Asked on April 13, 2011 5:46 am
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Please visit our forms section in your members dashboard for a generic template on medical necessity. Simply fill in the blank areas to support your reasoning for "medical necessity." As each patient's needs for treatment are different I cannot give you the reason for medical necessity, there must actually be medical necessity for the treatment.

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Answered on April 14, 2011 5:46 am
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