Dental procedures can be expensive, especially if you have multiple teeth that need treatment. While insurance companies typically cover preventative and restorative treatment, they tend to be a bit more restrictive with cosmetics. Cosmetic dentistry in Washington, DC, is usually not covered by most dental policies. However, that doesn’t mean it’s impossible to get coverage. Depending on your specific case, you may be able to get full or partial coverage for some cosmetic treatment.
Insurance Policies on Cosmetic Dentistry in Washington, DC
Saying for sure whether or not insurance will cover any procedure is difficult. Each dental insurance policy is different. Even within the same company, there could be a wide range of coverage options and availability. Whether or not you get coverage can often come down to the narrative attached to your insurance claim. If you get denied coverage but feel the treatment should have been covered, you can work with your dentist to resubmit with further documentation.
Pre-Authorization
Before getting any kind of dental treatment, you can send in a pre-authorization to your insurance company. This pre-authorization is submitted similarly to a claim, and many dental offices will help you submit one or submit it on your behalf. A pre-authorization notifies the insurance company ahead of time about the treatment plan your dentist recommended. Your insurance company will evaluate the treatment and determine what kind of coverage you can expect based on your specific policy. A pre-authorization is not a guarantee, however, and in some cases, you may experience a different final coverage after treatment.
Coverage for Restoration
The main purpose of cosmetic work is often to improve aesthetics. But it can also be used to help restore your teeth and prevent further damage. For example, say you have a chip in your tooth. While a dental crown can be a common restoration option, you may also be able to protect your tooth with porcelain veneers or dental bonding. However, it’s important to note that most insurance companies will only cover the treatment of the tooth that was damaged. So, if you decide to get four veneers when you only have one fractured tooth, your insurance company will likely only provide cover for the one veneer used on that tooth.
Dealing with a Claim Denial
If you submit a dental claim and it gets denied, that doesn’t necessarily mean you can’t get reimbursement for your dental work. There are many common errors made in the claims process that could result in a denial. The main ones include:
- Using the wrong treatment code
- Not including X-rays
- Little or no narrative/doctor notes attached
If your insurance company does deny your claim, call your dentist to discuss your options. They can help you understand your explanation of benefits and determine if there is a way to resubmit your claim for reimbursement.
If you need cosmetic treatment for any reason, Dupont Dental is here to help. Not only can we work to improve your smile and restore your bite, but we’re also committed to helping you work with your insurance company. Call us today at (202) 946-4720 to schedule a consultation and learn more about our cosmetic dentistry options.