MedicaidPrior AuthHigh impact
Provider Letter 2025-14: RE: DEN-6 Handicapping Labio-Lingual Deviation (HLD) Index Form Prior Authorization Process
Oklahoma SoonerCare·OK · Dentistry·Prior Authorization
Effective date
Jun 1, 2025
We identified it
Jun 20, 2026
Summary
Oklahoma Health Care Authority has updated the DEN-6 Handicapping Labio-Lingual Deviation Index Form used for orthodontic prior authorization. The revised form maintains the 30-point scoring system but includes clarified instructions and new 'automatic qualifier' conditions to better align with current dental standards.
Action Required
By June 1, 2025: SoonerCare dental providers must begin using the updated DEN-6 form and scoring sheet for all orthodontic prior authorization requests. By July 1, 2025: SoonerSelect dental providers must implement the updated form. Download the revised DEN-6 from the OHCA provider web page Forms section. Update prior authorization workflows to use only the new form after the respective effective dates. Contact OHCA at 800-522-0114 for SoonerCare questions or the respective dental plans for SoonerSelect issues.