There are several reasons why dental insurance claims may be denied. Some common reasons include:
Lack of coverage: The treatment or service provided may not be covered under the patient's dental insurance plan.
Pre-existing condition: The claim may have been denied due to a pre-existing condition exclusion in the patient's policy.
Missing information: The claim may have been denied due to incomplete, missing, or incorrect information on the claim or in the patient's records.
Maximum benefits reached: The patient may have reached their maximum benefit amount for the year, resulting in denial of the claim.
Frequency limitations: The treatment or service provided may be subject to frequency limitations or restrictions under the patient's policy.
Waiting period: The patient may be in a waiting period before certain treatments or services are covered under their policy.
Non-covered service: The treatment or service provided may not be covered at all by the patient's policy.
It's important to review your dental insurance policy carefully and understand your coverage limits and exclusions. If you have questions about a denied claim, contact your dental insurance provider to discuss the issue and determine the best course of action.
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