OAR 410-123-1000
Eligibility, Services Reviewed by the Division, Billing and the Dental Billing Invoice
(a)
Services requiring prior authorization (PA): See OAR 410-123-1160 (Prior Authorization) and 410-120-1320 (Authorization of Payment) for information about services that require PA or how to request PA.(b)
By Report Procedures:(A)
Request for payment for dental services listed as “by report” (BR) must be submitted with a full description of the procedure, including relevant operative or clinical history reports and/or radiographs. Payment for BR procedures will be approved in consultation with a Division dental consultant;(B)
Refer to the “Covered and Non-Covered Dental Services” data base, as referenced in OAR 410-123-1260 (OHP Dental Benefits), for a list of procedures noted as BR. See OAR 410-123-1220 (Coverage According to the Prioritized List of Health Services).
Source:
Rule 410-123-1000 — Eligibility, Services Reviewed by the Division, Billing and the Dental Billing Invoice, https://secure.sos.state.or.us/oard/view.action?ruleNumber=410-123-1000
.