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Dental Denial

Cigna Denied Your Dental / Oral Surgery?

Cigna Healthcare (The Cigna Group) denies 18.5% of claims on average. But 52% of appeals succeed when patients fight back. Your dental / oral surgery denial may have grounds for a successful appeal.

18.5%
Denial Rate
52%
Appeal Success
30-60 days
Typical Timeline
$2,000–$25,000
Typical Claim

Why Cigna Denies Dental / Oral Surgery

Classified as dental rather than medical

Cosmetic classification for reconstructive procedures

TMJ treatment not covered under medical plan

Cigna's Common Denial Tactics

Mass auto-denials (300,000 claims in 2 months at 1.2 seconds each)

Requiring step therapy for medications your doctor already tried

Denying claims as "experimental" despite FDA approval

How to Win Your Dental / Oral Surgery Appeal

Medical necessity documentation from oral surgeon

Evidence procedure is medical, not cosmetic (before/after imaging)

Referral from physician documenting medical complications

Laws That Protect You

ACA — Pediatric dental coverage requirements

State mandated dental coverage laws

Women's Health and Cancer Rights Act (for reconstructive)

Tips for Appealing to Cigna

Reference the ProPublica investigation into automated denials

Gather evidence of prior failed treatments to counter step therapy requirements

Obtain peer-reviewed studies supporting FDA-approved treatments

Ready to Fight Your Dental / Oral Surgery Denial?

Upload your denial letter and get an AI-powered analysis in minutes. We'll identify the weaknesses in Cigna's reasoning and build your appeal strategy.

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This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.

Cigna Denied Your Dental / Oral Surgery? Here's How to Appeal | Lysco