How do I file a Dental appeal?

You can file a dental appeal with Guardian by providing the supporting documentation through one of the methods below.

Method	Details
Email	Use the Secure Channel link.
Mail	Guardian PO Box 981572 El Paso, TX 79998-1572
Fax	PPO Dental plan appeals: 509-468-6356

Required Documentation

To determine if any additional documentation is required, refer to the below chart.

Service	Code	Required Material
Inlay/Onlay Crown Crown buildup Post and core Veneer Gingival flap Crown lengthening Bone graft Guided tissue regeneration Abutment crowns Surgical extraction Bone replacement graft	2500 - 2699 2700 - 2799 2950, 6973 2952, 2954, 6970, 6972, 6976 6979 2960, 2962 4240, 4241 4249 4263, 4264 4266, 4267 6700 - 6799 7210 7953	Radiographic image (X-ray)
Osseous surgery Root planning and scaling	4260, 4261 4341, 4342	Radiographic image (X-ray) and Periodontal charting
Tissue graft	4270, 4271, 4273, 4275, 4276	Periodontal charting

Note:

• Appeals can take up take 10 business days to be received if mailed and up to 2 business days if faxed or sent through Guardian's Secure Channel. Once received, they are sent for processing.

• Once Guardian begins processing, appeals that do not require additional review are processed within 10 business days.

• Appeals that require additional review are processed within 28 days as long as all the required documentation is included with the appeal.