AADC Newsroom
Guardian Reverses Third Molar Requirement After Feedback

Guardian Reverses Third Molar Requirement After Feedback.

The ADA News (8/23, Burger) reports that “the Guardian Life Insurance Company of America has reversed its position on third molars and associated sedation and anesthesia,” and the company now assures “dentists that claims will no longer be reviewed for medical necessity.” Dr. Randy S. Tillman, Guardian’s assistant vice president and chief dental officer, said, “We made updates to Guardian’s clinical policies that we thought would better align our claims practices with the marketplace and clinical norms.” However, after implementing the change, Dr. Tillman said “the feedback we received from our customers and professional community was that the new medical necessity review process did not align with customer expectations.” Dr. Steve Snyder, chair of the ADA Council on Dental Benefit Programs, said of the reversal, “This is just another example of the ADA advocating on behalf of all dentists nationwide.”

        Visit the ADA Center for Professional Success at Success. ADA.org and search for “Third Party Payer Advocacy” for more information on member support for third party issues.