Can I appeal a denied service?

Yes, it is possible to appeal a denied dental service under the Denti-Cal program. When a claim is denied, the provider typically receives a notification outlining the reason for the denial. The first step in the appeal process is to carefully review this notification to understand why the service was not authorized or approved. Providers may submit an appeal on behalf of the patient. It is important for the provider to gather any necessary documentation or evidence that supports the claim and demonstrates the medical necessity of the denied service. This information might include relevant clinical notes, diagnostic information, or additional supporting documentation. Once the appeal is prepared, it should be submitted to the appropriate address or department specified in the denial notice. Denti-Cal will then review the appeal and make a determination. Patients can also stay informed about the status of their appeal by consulting their dental provider. For more detailed guidance, including timelines and requirements, patients or providers may want to refer to the Denti-Cal website, which has up-to-date information on the appeals process and contact details.