Dental Consultant Journal

Do you know one of the top ten reasons dental claims are denied?  Failure to provide the reason for replacing a prosthesis, whether it be a crown or fixed bridge.  First of all, check the box on the claim form indicating that it is a replacement.  Provide the original date if know.  (Unfortunately plan frequency may disqualify replacement despite  the necessity)  Even if the reason is obvious on the film, include the reason in the note section of the claim.   Ex: decay under the margin,etc.  Invalid reasons for replacement include shade is not right, it's "old", gingiva has receded, exposing margins.  You must explain why the functionality of the prosthesis has been compromised.