Dental Insurance Coverages and ADA codes
I have a dental PPO plan though Anthem Blue Cross from my employer. Even though I have had it for a few years this was the first time I really used it for anything more then my free cleaning.
About a month ago I had some dental work that was rather costly. Now I get an additional billing from my dentist stated that the insurance did not pay out much for the full porcelain crown that I got. However my dental plan says they will pay out half the cost for crowns.
Calling up the dental insurance company right away I was told that they do not cover out that ADA code but will cover up to the UCR rate for a different crown…. It really seemed like double talk to me. A crown is a crown! What do they mean ADA code? Please help me understand.