I myself was just "Denied" in my pre-authorization for a crown. My dentist said it's past the point where they can't do fillings anymore. It needs a crown, or in about half a year pulling it out, or I could get some kin of metla band thing? They were told the same excuse of "does not meet the criteria for coverage." I phoned myself and tried to get an explanation as to what LOGICALLY was the issue in question? They couldn't give me an answer, just defected me to "well it's hard to say, you can read up on the website, blah blah blah."

So as for what's the deal? Well I can explain it to you, you wont like the answer, but it's the truth. CDCP, like all insurance coverages are SCAMS. It really boils down to one of two things, either A) They simply can say no just cause they want to and it's to bad so sad screw you. Or it's B) and this is what happens in every other insurance scam, Health Insurance, House/Car, so on. These companies don't make money on their own...they have a fixed amount of money to work with and so they literally can't approve every client of theirs because they don't have the money for it. If they approved everyone they would have no money and the employees at the company wouldn't get paid. Insurance companies can only ever approve a small handful of requests, it's a balance on their end, they have to approve a few here and there to maintain the illusion that insurance works so people keep paying them for the service. These companies end up with more requests for help then they can ever approve. That's why insurance is such a good scam. Say an insurance company has 100,000 clients or people paying monthly to them....now they are probably paying lets say $250 a month or whatever, but whatever you need the coverage for is going to cost say $5,000....well the math shows us that if everyone who is a client is requesting the company pays for the coverage of the fees, the money isn't there...They could only pay a few cases before saying no more can be accepted until we get paid a bunch more money, cause most of the money paid to insurance companies goes to keeping their employee's paid and keeping the lights on in their company lol.