Prior authorization for dental practices
Dental payers ask for tooth-level evidence: which tooth, which surfaces, what the radiographs show, what was tried before. Genkō Prior Auth collects those findings in a structured dental form and drafts a payer-aware packet from them. Your team reviews, edits, locks and submits it.
Updated · Markdown version
What it collects
The dental findings form follows what a dental reviewer looks for:
| Group | Fields |
|---|---|
| Presentation | Chief complaint, tooth numbers (universal system, 1-32 or A-T), surfaces, quadrants, clinical findings, radiographs taken. |
| Periodontal charting | Deepest pocket in millimetres, number of sites 4 mm or deeper, bleeding on probing, charting notes. |
| History | Prior treatment and whether it failed. |
Procedure and diagnosis codes
Procedure codes are searched from a curated CDT list (with CPT available for medically billed services) across diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, implant, oral surgery, orthodontic and adjunctive categories. Diagnoses use an ICD-10-CM search. You can also type a code that is not in the list.
What the packet contains
- A clinical justification built from your findings, history and notes.
- A supporting-documentation summary naming the radiographs and charting you recorded.
- A request letter to the payer's reviewer.
- A list of what the payer may expect that you have not provided, such as a pre-operative X-ray.
What stays with your team
Prior Auth never sends anything to a payer. Your team edits every section, locks the packet (permanent), downloads the PDF and submits it through the payer's own channel, then records the decision. If it is denied, an appeal is drafted for review the same way. See Getting started.
Where things stand
Early access, by invitation, on synthetic data only. No real patient information should be entered, and no HIPAA compliance claim is made. Request early access.