Medically Necessary. In general, We will not Cover any dental service, procedure, treatment, test or device that We determine is not Medically Necessary. If an External Appeal Agent certified by the State overturns Our denial, however, We will Cover the service, procedure, treatment, test or device for which coverage has been denied, to the extent that such service, procedure, treatment, test or device, is otherwise Covered under the terms of this Contract.
Appears in 43 contracts
Samples: www.bcbswny.com, Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract
Medically Necessary. In general, We will not Cover any dental service, procedure, treatment, test or device that We determine is not Medically Necessary. If an External Appeal Agent certified by the State overturns Our denial, however, We will Cover the service, procedure, treatment, test or device for which coverage has been denied, to the extent that such service, procedure, treatment, test or device, device is otherwise Covered under the terms of this Contract.
Appears in 10 contracts
Samples: Preferred Provider, www1.deltadentalins.com, Preferred Provider
Medically Necessary. In general, We will not Cover any dental service, procedure, treatment, test or device that We determine is not Medically Necessary. If an External Appeal Agent certified by the State overturns Our denial, however, We will Cover the service, procedure, treatment, test or device for which coverage has been denied, to the extent that such service, procedure, treatment, test or device, is otherwise Covered under the terms of this ContractPolicy.
Appears in 8 contracts
Samples: assets.ctfassets.net, mydental.guardianlife.com, assets.ctfassets.net
Medically Necessary. In general, We will not Cover any dental service, procedure, treatment, test or device that We determine is not Medically Necessary. If an External Appeal Agent certified by the State overturns Our denial, however, We will Cover the service, procedure, treatment, test or device device, for which coverage has been denied, to the extent that such service, procedure, treatment, test or device, device is otherwise Covered under the terms of this ContractPolicy.
Appears in 2 contracts
Samples: healthplex.com, healthplex.com
Medically Necessary. In general, We will not Cover any dental vision service, procedure, treatment, test or device that We determine is not Medically Necessary. If an External Appeal Agent certified by the State overturns Our denial, however, We will Cover the service, procedure, treatment, test or device for which coverage has been denied, to the extent that such service, procedure, treatment, test or device, device is otherwise Covered under the terms of this ContractCertificate.
Appears in 1 contract
Samples: www.aetnastudenthealth.com
