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.
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?
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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.