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Washington State Dental Association

Medicaid Update

Effective September 15, 2014, the Health Care Authority (HCA) will require providers to send expedited authorization requests via email to In the body of the email providers will need to indicate the medical reason to prioritize the request and the urgency of a client’s appointment date. Please note that extraction authorization requests will no longer be expedited unless emailed to If providers do not receive a response to an extraction request seven days prior to a client’s appointment, please send a follow up email to

When submitting extraction authorization requests, please make sure to include all appropriate medical necessity documentation, including x-rays and tooth charts when required. The HCA is requesting that providers start using the new General Information for Authorization (GIA) form # 13-835 with the new service type of “extractions” or “dentures with extractions.” As of October 1, 2014, the new GIA form will be required and any requests that are not submitted on the new form may be returned as invalid.

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