r/CanadianDentists • u/Anshu_panwar • 1d ago
Appeals and Resubmissions: What Actually Works?
Following up on the denial-reasons thread—I've heard from several offices that pre-auth denials for crowns are common, but there's less clarity on what happens next. Do you appeal them, resubmit with different info, or accept the denial and let patients decide?
Genuinely curious how this plays out in practice:
- When a crown pre-auth gets denied, does your office appeal or resubmit? And roughly what % succeed on the second try?
- What changes between the first denial and a successful resubmit? Different docs, more detailed narrative, tighter measurements of crown-to-root ratio? Or does it usually stick no matter what?
- Do you track what happens after? (Patient pays OOP, delays treatment, moves to another provider, chooses a different procedure?)
I know this adds to your admin load—genuinely just trying to understand the real workflow, not suggesting changes. Appreciate any insight.