My wife recently had some dental work performed on three teeth, diagnosed by the local dentist that resulted in three crowns. Specifically, the local dentist took xrays that revealed "three old restorations that were leaking, causing decay around the old restoration and severe sensitivity to my wife. When the initial claim was denied, the dentist wrote an extensive break down of the problem for each tooth and forwarded that to the insurance company. The dentist also provided the insurance company with "pre-operative x-rays, pre-operative intra-oral photos, post operative photos and post seat x-rays". The insurance company has stated that this claim "has been through 2 advisor reviews". I am not sure what that means, but it appears to me that the insurance company is second guessing the local dentist. How can I be sure that the insurance company is having a real peer review and not by some bureaucratic board of reviewers. Since the dental office has filed a second request for reconsideration and it has resulted in the same denial, I am afraid I don't know what steps to take next. Is there another source within United Concordia Dental Insurance Company that I can appeal my case to? Please help. By the way, the negotiated fee between our dentist and insurance company for this service is $1,915.56, and with our Hi-Option dental insurance plan, we were billed and paid 50% of the that cost, or $957.78. Without the insurance company reimbursement, it looks like we will be on the hook for the remaining amount.