My question involves insurance law for the state of: Texas. My wife went to Ukraine to have various work done including 3 bridges. The Ukraine dentist receipt included a $1400 item for the 3 bridges. Delta Dental denied the claim saying we needed a separate claim item from the dentist for each bridge, also identifying teeth involved on each bridge. I had included a chart showing teeth involved with each bridge, but it was my chart and not the dentists. Is this a legal basis for denying the claim? Also they have procrastinated greatly in processing this claim (6 months). According to ERISA regulations, I thought 90 days was the max they could delay a claim without written notification? Also are the US procedure codes required to be given by a foreign dentist?
thanks for any info.