Dental Pretreatment Estimates and Preauthorization

Policy Number: DP-X-013

Last Updated: Sept. 15, 2022

What is the difference between a pretreatment estimate and a preauthorization?

A pretreatment estimate is a request for approval of dental benefits prior to the service. A preauthorization is a written request for approval of medical benefits prior to performing certain services which require a medical decision.  

Pretreatment Estimates  

A pretreatment estimate should be submitted to Blue Cross and Blue Shield of Nebraska (BCBSNE) for the treatment plan, excluding examinations, prophylaxis, radiographs, oral surgery and emergency treatment. Services not included on the pretreatment form should be filed separately.  

Preoperative X-rays should be sent with the pretreatment estimate only for anterior crowns, abutments with A/B coverage, multiple restorations (same tooth) and accident-related care. In all other cases, BCBSNE will request them on an as-needed basis. Physical (not digital) X-rays will be returned to the dentist’s office shortly after processing is completed.  

Pretreatment estimates are valid for six months. 

Dental Services Exempt from Preauthorization  

If the patient is age 8 and under or developmentally disabled and receiving dental anesthesia, preauthorization is not required.