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How to Submit a Dental Predetermination

June 6, 2024

Dental predeterminations can be submitted in advance to verify a member’s benefits before services are started. This helps in coordinating financial arrangements for reduced or uncovered services.

You can submit a dental predetermination request as you’d normally submit a claim through:

Use the code check tool in Availity to see which procedure codes recommend pre-determination.

For dental prior authorization for the following services, you can fax a dental prior authorization form to 425-918-5956.

  • Cosmetic and reconstruction services
  • General anesthesia and facility services related to dental treatment
  • Orthodontic services for treatment of congenital craniofacial anomalies
  • Orthognathic surgery
  • Temporomandibular joint disorder (TMJ)

More resources
Visit our Dental Resources web page for quick answers to common questions.