Alert: Under the Code of Federal Regulations, Chapter 32, Section 199.13
a non-participating provider is not an appropriate appealing party.
Therefore, if you disagree with the Dental Advisor's opinion, you may
appeal the determination if appointed in writing, by the beneficiary, to
act as his/her representative. Should you be appointed as a
representative, submit a copy of this letter, a signed statement
explaining the matter in which you disagree, and any radiographs and
relevant information to the subscriber's Dental insurance carrier within
90 days from the date of this letter.
