Question: Do you have any great narratives for submitting Delta Dental SRP benefit claims?
We are looking for a good narrative for SRP. We have found that many of our claims to Delta Dental, although they tell us when we call for benefits, that they allow for all 4 quads in the same visit with documentation, then, deny it stating that they don’t find it necessary by consultant review. We only submit for SRP with probing depths over 4mm and we send the periodontal chart, the chart notes and x-rays. We often even submit with intraoral photos showing calculus build up and inflammation but they still seem to deny many of our claims for SRP to Delta Dental. We aren’t seeing that for all other insurance companies but want to make sure we are safeguarding ourselves. Please let us know if you have a great narrative that you can share with us.
ANSWER: We certainly understand the frustrations with insurance companies and their propensity to deny claims. We must always remember the insurance belongs to the patient so we need to start by always letting the patient know we are doing the best for their dental health by providing the recommended treatment.