Dental Insurance Question
This is a dental practice and dental insurance question. I was told by an IN-NETWORK dentist that I need two crowns. I requested a pre-determination estimate of costs associated with both crowns. It took a long while, but I finally got an estimate. The dentist used code D2740 for both crowns themselves, then additional D2950 for "crown buildup w/pins" for both, and then additional D4249 for "crown lengthening" again on both. The insurance only approved the two "crowns" (D2740), one of the "buildups" (D2950), and denied both "crown lengthenings" (D4249). I asked the office to resubmit with medical justification so that my insurance will cover. My insurance will cover 60% of a crown. I have waited weeks to resolve this and then learned they did not even do the resubmission. So I asked again for them to do it, and still wait. Why is the crown submission (D2740) not inclusive of the other two procedures? How do I get this resolved? I can not pay thousands of dollars. With the way the matter stands on the current estimate, my bill will be nearly $4000 AFTER any insurance payments based on how they are billing for just two crowns! Without any insurance covering any of it, the cost is estimated at $7576. One of the teeth has never even had a filling, but the dentist wants to do crowns because the decay is close to the gumline or root, I guess, on both. I do not know how to question this to get my crown covered at 60%. Please, help!