Waiting period not met: what it means and what to do
Some plans don't pay for certain services, often fillings, crowns or dentures, until the patient has been covered for a set time, such as 6 or 12 months.
- “Waiting period has not been satisfied”
- “Service not covered during waiting period”
What to check first
- The patient's coverage start date and the waiting period for this kind of service.
- Whether the plan waives the waiting period for people who had other dental coverage right before. Some employer plans do.
What to do
If the patient qualifies for a waiver, send proof of the prior coverage. Otherwise the patient owes the fee, or the work can wait until the period ends.
Stop it next time
Check waiting periods for every service on the treatment plan before quoting.
Insurers word these differently, and many print a numbered reason code too. Read the words on the explanation of benefits; they say which of these it is.
Sources
Read November 11, 2026. Where a source describes one insurer's plans, we say so.
Get the patient's share in dollars, from the benefits page
Most denials can be seen coming on the benefits page. Tabruns reads the coverage, deductible, yearly maximum, waiting periods and frequency limits from the insurer's portal and works out what the patient owes. Patient details stay on the office computer.
Not ready? Try the free patient portion calculator.
Other denials
- Frequency limit reached
- Yearly maximum reached
- Not a covered benefit
- Alternate benefit applied
- Included in another procedure
- More information needed
- Patient not covered on the date of service
- Other insurance information needed
- Filed after the deadline
- Missing tooth clause
- Not supported by the records
- Replacement too soon
- Applied to deductible