For someone who doesn’t deal with dental insurance every day, understanding your benefits can be overwhelming. For example, your plan may not cover something that you think it should and you may be wondering why. Here are some common procedures and reasons why some insurance claims in Napa, CA get denied.
Most policies will pay for a certain procedure every so often. For example, you can have two cleanings per year, a crown replaced every five years, or a panorex x-ray taken every three years.
If you exceed the frequency amount, your insurance claim will be denied, and you’ll be responsible for paying the balance of your procedure.
Missing Tooth Clause
Let’s say you want to replace a missing tooth with a bridge. If you didn’t have dental coverage at the time the tooth was extracted, or if you were under a different policy, then your current plan will not cover having the tooth replaced.
Teeth whitening and porcelain veneers are considered cosmetic dentistry because they are elective procedures, and aren’t covered by dental insurance companies.
Dental implants are a great way to maintain a healthy smile after having a tooth extracted. Unfortunately, some insurance companies out there still feel that dental implants are elective, making it difficult to claim them towards your coverage. Fortunately, this is starting to change and most insurers realize the value of the long lasting benefits of modern implant restorations.
Getting the Most Out Of Your Insurance Benefits
The staff of Alora Dentistry in Napa, CA are happy to help you understand your dental benefits and answer any questions that you may have. We work closely with your carrier to help you maximize your coverage. Come visit us today to learn how.