Medicaid Dental Appeal Process

Summary

The user is seeking to appeal a Medicaid denial for a root canal and crown procedure in New York. They were informed about the importance of medical necessity documentation and the process of requesting a Fair Hearing. They were also provided with contact information for legal organizations that can assist with Medicaid appeals, including the Legal Aid Society of New York, New York Legal Assistance Group (NYLAG), and Urban Justice Project.

Full Conversation

NY >NYC
What is the reason given by Healthfirst Medicaid for denying your request?

General Information:
- In NY, you can request a Fair Hearing if Medicaid denies your request.
- Contact: NYC Medicaid Fair Hearing Office, Phone: *-*-*.
only if it is for abridge they do the root canal.
What is the medical reason provided by your dentist for the need of root canal and crown for tooth * & *?

General Information:
- Medicaid coverage varies for dental procedures.
- It's important to have a medical necessity for the procedure.
That I must save the tooth's for chewing.
What documentation do you have from your dentist supporting this medical necessity?

General Information:
- Proper documentation can strengthen your appeal.
- Contact your dentist for necessary paperwork.
I have a note from another dentist that went see yesterday as emergency stating that the tooth's are infected and they must be saved , I am taking antibiotics for infection of * & *.
What steps have you taken so far in the appeal process?

General Information:
- You should submit all relevant medical documents in your appeal.
- Keep copies of all correspondence related to your case.
I appeal the denied twice . it was denied twice . I am looking for legal organisations to appeal for fair hearing as soon as possibe.
What legal organizations have you reached out to for assistance with your appeal?

General Information:
- Legal Aid Society of New York can assist with Medicaid appeals.
- Contact: *-*-*.
None , please I have the names of different organizations then Legal aid.
Sure, you can also reach out to New York Legal Assistance Group (NYLAG). Their contact number is *-*-*.
I Urban Justice do appeals ?
Yes, Urban Justice Project does handle appeals. You can contact them at (*) *-*. They are located at * William St, New York, NY *.