PM 20-14-02: Prior Approval

WAG 20-14-02

To ensure payment, a provider must call DentaQuest before providing initial or periodic exams and X-rays, to confirm that the client is eligible. All other services must have a treatment plan submitted for prior approval.

DentaQuest's Office Reference Manual for Dentists lists the services that require prior approval. DentaQuest handles prior and post approval. The decision on the request for prior approval must be made within 30 days.