#255713
niermanpm
Participant

Usually a “not eligible” denial means that you just don”t have this benefit under your specific plan or did not meet the criteria for the plan to pay for the service. I would call the insurance company first to inquire about the claim. and then I would talk to the dental office to make sure they submitted all the information that is needed to have the insurance process it correctly. Did the office warn you taht it was something that might not be covered by the insurance plan? Did the dental office send you a bill for the charges or was this just on the explanation of benefits? Sometimes the dental office is just as surprised as you are to receive the denial and is trying to get it paid by the insurance company.