Can I bill for a crown that the lab delivered but was never seated?

Answer

You can bill the insurance for the crown, but you will need to send an explanation as to why the crown was not seated in addition to sending a narrative and documentation to justify the crown.

In the narrative, include the "regular" documentation, pre treatment x-ray and diagnostic narrative (or pre-d) justifying the crown. Send a copy of the lab prescription and the lab bill for the crown. Additionally, explain what you did to follow-through with the delivery of the crown and provide a copy of any documentation you have regarding your attempts to appoint and/or no shows.

It would help to have documentation that a certified letter was sent to the patient (i.e., include a copy of the letter), encouraging the patient to complete treatment and explaining the possible negative outcomes should the crown not be delivered. The date of service on the claim should be the date of prep with the reason it was not seated explained in the narrative.

Best case scenario, the insurance will pay its contracted amount. Some carriers will at least pay a pro-rated amount to compensate for the lab bill and chair time. Others will pay nothing. All you can do is bill the full amount, explain the circumstances, and let the carrier decide what is payable according to the terms of the dental plan contract.