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Pre-Authorisation Requirements

Crown & Bridge Requirements

​The following are required for crown and bridge pre-authorisations:

  • An x-ray clearly showing the entire clinical crown, the neck and the upper part of the alveolar bone; typically a peri-apical for anterior teeth or a bite wing would suffice
  • The tooth number in FDI format ( i.e. two-digit numbering)
  • The major clinical code to be used: e.g. 8409 (crown – porcelain/ceramic); 8411 (crown – porcelain with metal). If a post is envisaged, please tell us the primary code for the post and/or core
  • A detailed laboratory quote
  • In the case of a bridge, information about any further planned treatments is required along with the above information. For example, this could be a short description about what is planned for other missing or damaged teeth

    Note: Further clinical information may be requested to support an authorisation request.

Email: crowns@denis.co.za
Fax
:    0866 770 336
Post:   Private Bag X1, Century City, 7446

Implant Requirements

The following are required for implant pre-authorisations:

  • A full treatment plan and quote including prosthodontic phase (i.e. all 3 phases)
  • X-rays
  • Additional motivation

Email: ortho@denis.co.za
Fax
:    0866 770 336
Post:   Private Bag X1, Century City, 7446

Orthodontic Requirements

The following are required for orthodontic pre-authorisations:

  • An orthodontic treatment plan
  • A panoramic x-ray
  • Pre-treatment photographs showing the bite in occlusion: the front view, left-side view and right-side view
  • Pre-treatment photographs showing a full occlusal view of the mandibula and the maxilla
  • A cephalometric x-ray

    Note:
  • Please submit clear copies of documents and radiographs to ensure authorisation requests are processed as fast as possible.
  • Further clinical information may be requested to support an authorisation request.

Email: ortho@denis.co.za
Fax
:    0866 770 336
Post:   Private Bag X1, Century City, 7446

Periodontic Requirements

The following are required for periodontic pre-authorisations:

  • A full periodontic chart of CPITN-scoring
  • A full treatment plan
  • X-rays
  • A detailed maintenance plan for the remainder of the benefit year

    Note:
  • Please submit clear copies of documents and radiographs to ensure authorisation requests are processed as fast as possible.
  • Further clinical information may be requested to support an authorisation request.
     

Email: perio@denis.co.za
Fax: 0866 770 336
Post: Private Bag X1, Century City, 7446

In-hospital Requirements

The following are required for in-hospital pre-authorisations:

  • Hospital practice number
  • Anaesthetist practice number
  • Treating clinician
  • Hospital admission date
  • Procedure code(s) with ICD10 code(s) and where relevant the applicable tooth numbers
  • Main complaint
  • If applicable, medical report of special medical conditions
  • X-rays are needed if a 54 practice applies for the removal of impactions
  • X-rays are needed if a 62 practice applies for two or fewer impactions

    Note:
  • Please note that all hospital cases are assessed individually.
  • Further clinical information may be requested to support an authorisation request.


Email: hospitalenq@denis.co.za
Fax: 0866 770 336
Post: Private Bag X1, Century City, 7446

Conscious Sedation

​The following are required for conscious sedation pre-authorisations:

  • Anaesthetist practice number
  • Treating clinician
  • Proposed treatment date
  • Procedure code(s) with ICD10 code(s) and where relevant the applicable tooth numbers
  • Main complaint
  • If applicable, medical report of special medical conditions
  • X-rays are needed if a 54 practice applies for the removal of impactions
  • X-rays are needed if a 62 practice applies for two or fewer impactions

    Note:
  • Please note that all sedation cases are assessed individually.
  • Further clinical information may be requested to support an authorisation request.
     

Email: hospitalenq@denis.co.za
Fax: 0866 770 336
Post: Private Bag X1, Century City, 7446

Denture Requirements

​The following are required for plastic and partial metal frame denture pre-authorisations:

  •     For partial dentures, the missing tooth numbers
  •     For full dentures, an indication of the applicable jaw


Tel :  0861 033 647
Email: customercare@denis.co.za
Fax:  0866 770 336
Post: Private Bag X1, Century City, 7446

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