Clinical Review Updates

At Washington Dental Service we routinely re-evaluate our processing policies to make sure benefit determinations support the policy provisions of our customers. Even though clinical criteria may not change, WDS periodically increases the number of claims and predeterminations being reviewed as our capacity for clinical review allows. When these kinds of changes occur, you may see increased requests for documentation you have not been asked for in the past. In order to avoid delays in claim payment, please check this page often to determine if any review changes have occurred. Submitting supporting documentation with the original claim enables us to provide the fastest possible turn-around time.

• Effective immediately: Please submit a diagnostic quality image and narrative for all core buildups

View a complete list of our current documentation requirements.

Updated 1/26/2011