message board 360 United Concordia - Knows Periodontal Disease VIEWS in 1 day Townies share their woes when it comes to getting insurance to pay out on scaling and root planing jcr87 Member Since: 04/04/06 Post: 1 of 58 We got a denial for scaling and root planing on all quadrants from United Concordia. We are fighting it. We submitted the claim with full-mouth pocket probing (multiple 4mm, 5mm and 6mm pockets) and FMX radiographs. Patient is a 34-year-old female. I am just attaching bitewings and selective radiographs for brevity. The denial was not based on them not having enough information; it was because it did not meet their criteria. What do you all think? Photographs were sent when we appealed the denial, not in the original claim submission. ■ 8/15/2019 Practice Whisperer Member Since: 07/22/11 Post: 3 of 58 Did you include full measurements of gingival margins (GM)? This is the No. 1 reason for denials. No GM = no clinical attachment level (CAL). No CAL = no possible way to diagnose, and they know it. ■ 8/15/2019 Jen Harvey Member Since: 02/02/17 Post: 6 of 58 With all that calculus, did you by chance do a full-mouth disinfection (FMD) first and then perio probe at a later date (week or so later)? ■ 8/15/2019 jcr87 Member Since: 04/04/06 Post: 7 of 58 36 No FMD in our office. We went straight to scaling and root planing. ■ DECEMBER 2019 // dentaltown.com 8/15/2019http://www.dentaltown.com