Dental preauthorization for clinics: how the process works

The clinic’s side of preauthorization

Preauthorization exists so the plan can review a treatment before it happens. The clinic’s job is to hand the plan a clear picture: what treatment is planned, why it’s needed, and what the records show.

For most clinics that means the same loop every time — identify the treatments that need approval, pull the records, write the request, submit it, and track the decision until it lands.

The treatment narrative

The narrative is the written why: the diagnosis, the planned treatment, and the clinical reasoning. It’s the part that reads like the practice — and the part that slows clinics down when it’s improvised from scratch each time.

Supporting records

X-rays, chart notes, and other records back the narrative. A complete file is easier to approve; an incomplete one gets returned for more information, and that’s where hold-ups usually happen.

Submitting and tracking

Submit to the right plan, note the reference, and track the outcome. Decisions come back as approvals, partial approvals, or requests for more information — each with its own follow-up.

Tracking is where paperwork quietly multiplies. A clinic with a clear view of outstanding requests and their statuses saves itself the “where is this one?” calls.

Spending paperwork time on people instead

Every request that is prepared well the first time is a block of staff time returned to the clinic’s real work. Ophi is building tools that help dental teams prepare preauthorization requests with less of that time spent on paperwork.