@dr.k.sislow: What is the magic % of lost tooth structure to get a crown approved? I don’t know. It’s like Goldilocks with these insurance companies. A broken cusp is pretty much an automatic crown in a dental office. The filling material simply will not hold up to biting forces on an entire cusp. It needs either a crown or onlay. Insurance rarely pays for onlays. In this case, he needed a crown. First they said not enough missing tooth structure. Then they said there was too much tooth structure missing and the tooth is non restorable. ??? #dentist #insurance #healthcare #dentistry #privatepractice . . Disclaimer: This is for informational and educational purposes. Should not be regarded as medical advice or replace the advice of your dentist/doctor. . . Hi! I’m Katherine Sislow, a dentist in Colorado who focuses on predictable family dentistry, with a focus on cosmetics and geriatrics! Wondering if I can help you or a loved one? Reach out! . . Sislow Family Dental Located in Greenwood Village, CO . . Interested in a consultation? Email: [email protected]
I work in customer service for dental providers at an insurance company. Most of the time, it’s really hard to explain why claims were denied because, in many cases, the denial was simply due to mistakes made by the insurance company’s claims department. 🤦🏻♀️And of course, we end up taking the blame for it. It’s really hard to work in customer service when there are no proper processes in place.
2026-05-22 23:58:15
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Shenker :
Turn fee for service.
2026-05-22 20:56:40
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jdpa_health :
Claim denials must be regulated! Medical professionals must hold legal power smh
2026-06-27 16:12:21
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It'sMeLey :
that's hilarious 😂 I understand where you're coming from. I also work in Healthcare but in member services.
2026-05-23 12:53:12
4
Ashley Banesh :
So who’s the doctor here? The insurance company or the doctor?
2026-05-22 15:21:41
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JamesJJ :
I work with insurance as a rep. they review/process the claim from lower to higher cost per procedure, try that if it's work. 🙂
2026-05-22 21:39:43
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Rhe and Jo :
I used to work at UHC dental as a representative I got intel that 2 out of 10 claims will get denied and that claim will never be paid thats how the insurance roll their money they never pay all their claims lol.
2026-06-14 00:01:07
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lifewaleece :
“Significant loss of tooth structure requires build up and crown “ - magic ins sentence attach pre op pa
2026-05-22 16:34:42
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katieoswald817 :
our biggest issue right now is bone graft 7953 I can't get any insurance to pay for that even when it says it's covered
2026-05-22 18:18:30
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Mukuro Rukudo :
maybe a photograph that shows Build Up in place if there's any
2026-05-24 04:42:26
1
💙💙 Kelly P 💙💙 :
what procedure gets done if it really is too much tooth loss for a crown? if that's wvwn a possibility lol
2026-05-24 02:14:39
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Manderooo :
Patient needs a bridge. MetLife questioned which tooth was getting the bridge, which was getting the Pontic. We had supplied X-rays and narrative. 🫥
2026-05-22 16:48:27
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Jon :
I’m not in the medical field but I’ve followed lots of medical people: dentists, pharmacists, physical therapists, family medicine docs, neurologists. It reinforced what I already knew: insurance and the medical system and bureaucracy sucks. And patients and by extension the medical professionals sometimes suffer bc of it.
2026-05-22 19:53:20
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yahmom :
can we chat gpt the responses 😭
2026-05-27 14:29:10
1
seximexi007 :
F - DENTAL MEDICA HOME CAR INSURANCE
2026-05-28 16:00:14
1
meibostouch :
….you’re kidding
2026-05-22 21:01:34
1
el chico :
what was the insurance company?
2026-05-22 16:42:57
1
Scott :
Are we surprised?
2026-05-22 15:59:32
1
Patrick :
Of course they did...
2026-05-23 00:05:31
1
Chris 🥓 :
no dental insurance lol
2026-06-03 18:46:29
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Keven Lippold :
nice
2026-06-04 13:47:59
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️katrina c. requiza :
Insurance companies in the US will do everything so they won't pay for the claim 😂😅
2026-06-21 20:27:08
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Chris 🥓 :
Internet always denied at first
2026-06-03 18:48:35
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SmileDentist :
Must be a delta dental insurance but that is what we all are up against.
2026-06-04 03:47:57
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