Prior Approval (approval ahead of time) is required for many dental procedures.
Forms
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| Form 343 |
Dental Prior Authorization - Revised 12/10/20 |
| Form 404 |
Administrative Review |
| Instructions |
Submitting Dental Administrative Review of Claims (Enhancement to Dental Administrative Review of Claims Process) - Effective 4/15/24 |
| Form 471 |
Revision to Prior Authorization |