SPRINGFIELD (WGEM) – Illinois state lawmakers are moving to ban dental insurance companies from denying coverage for procedures they’ve already approved.
The state House of Representatives passed a bill with broad bipartisan support Tuesday banning insurers from denying claims for procedures it already gave prior authorization.
Dentists say they’ll submit a treatment plan to a patient’s insurance company before performing a potentially expensive procedure. When they submit the claim to be reimbursed for their work, an insurance company will then deny that claim.
“This is unfair and it’s not transparent to the patient and we want this to be changed,” said Dr. Larry Osborne, a dentist from Decatur.
If the bill becomes law, insurance companies would still be able to deny a claim if the treatment is vastly different from the plan originally submitted, if a patient’s benefit limit is reached or if circumstances changed making the treatment no longer necessary.
Copyright 2024 WGEM. All rights reserved.