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dental-insurance-preauth

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Write a dental pre-authorisation request or claim narrative that gets approved the first time — the diagnosis, the documented failure of lesser treatment, and the attachments a reviewer needs, assembled in the order they assess them. Use when asked to write a pre-auth, submit a predetermination, appeal a denied dental claim, or write a narrative for a crown, implant, or perio case. Produces the narrative, the supporting-evidence checklist, the attachment list, and an appeal letter if the claim was already denied. Administrative support only; clinical justification must come from the treating clinician's own findings.

plugins/pm-dentistry/skills/dental-insurance-preauth/SKILL.md

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Nov 9, 2026
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# Dental Pre-Authorisation & Claim Narrative

Most dental denials are not clinical disagreements — they are missing sentences. The reviewer needs the diagnosis, evidence that something less invasive was considered or tried, and images that show what you are describing. This assembles all three in the order the reviewer works through them, and writes the appeal when the first submission failed anyway.

## What This Skill Produces

- **The clinical narrative** — diagnosis, history, and why this treatment rather than a lesser one, in a reviewer's vocabulary
- **The evidence checklist** — radiographs, photos, charting, and dates the plan will expect for this procedure class
- **The lesser-treatment paragraph** — what was tried or considered and why it is not adequate, which is the sentence most denials hinge on
- **The attachment list** — what to send, labelled so the reviewer can match each image to the claim
- **An appeal letter** — if already denied, rebutting the stated reason specifically rather than resubmitting the same file
- **A denial-risk read** — what in this submission is most likely to draw a request for more information

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