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 am new to orthodontic and dental billing. The patient may have a 27-month or 30-month treatment, but our office likes to have the bill paid in 24 months. So the private pay part is divided up, % down and 24 monthly payments. In submitting claims for insurance, I have seen others put in the number of months of treatment remainnig (box 42 J400) accurately as 27 or 30, but then put the code, total case fee, initial banding fee, and something like "24 months to be billed at $____ per month." Is it okay to bill insurance this way?