Dental Preauthorization

Effective January 1, 2026

To ensure medical necessity and prevent service duplication, PA is required for certain procedures. Our new system is programmed to automatically detect and verify PA requirements during claim processing. Please update your processes and notify staff to ensure compliance.

This list shows dental codes that require preauthorization. Claims for these procedures without PA will be denied.

Note: We will no longer accept unspecified CDT codes (e.g., D9999) on submitted claims. All procedures must be reported using the most specific and appropriate CDT code available. Claims submitted with unspecified codes may be denied or delayed pending resubmission with proper coding.

Steps to Request PA:

1. Log in to the New Portal and choose Office Management-->Communications Archive from the menu on top.
2. Choose a provider from your office.
3. Find the authorization form under the Document Type drop-down menu.
4. Complete form and return to us via Message Center in the New Portal.

Questions? Contact us via the Message Center in the New Portal or call us at 801-366-7555.