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Dental Information
                                                                                                                Dental Provider Policy Manual
                                                                                                                Dental Billing Manual
                                                                                                                                                                                                                                                     
Dental Invitation
Dental Fee Schedules:        pdf format        Excel Format


FREQUENTLY ASKED QUESTIONS
DENTAL PROCESSING
Q: Is a Prior Authorization (PA) required for dental procedures?
A: A prior authorization is needed for all orthodontic services.  Providers should review the fee schedule to determine if the procedure requires a PA.
Q: Is a radiograph required when the PA is submitted?
A: The following codes require radiographs D2750 – D2752, D5211, D5212 and D9940.
Q: Is there an age limit for the procedure code?
A: Some dental codes have age limits. Provides should review their fee schedule to determine if the procedure code is billable for the patient.
Q: What is the status of my PA?
A: You may use the Envision website (https://msmedicaid.acs-inc.com/msenvision/) to retrieve current information regarding your PA.  Upon completion of the review the system will be updated to reflect the decision.  
Q: How do I receive additional PA forms?
A: You may use the  reorder form to order request additional PA forms from ACS or call 1-800-884-3222.
Q: Can I appeal a PA if it is denied?
A: Yes, if you have additional information that supports the medical necessity of the procedure.
Q: What should I do if I submitted a PA and the claim still denies?
A: First review the claim to ensure you submitted it correctly.  If the claim was filed correctly send a copy of the claim with the supporting documentation to ACS advising them that the claim denied incorrectly.
Q:

Can providers bill Medicaid beneficiaries for missed appointments?

A: According to the Center for Medicare and Medicaid Services (CMS) and the Oral Health Technical Advisory Group, a provider can not bill a Medicaid beneficiary for missed appointments. Current Medicaid policy does not allow for billing beneficiaries for missed appointments because a service was not provided; therefore, no reimbursement is available. In addition, missed appointments are not a reimbursable Medicaid service, but are considered a part of providers’ overall cost of doing business. In no case may providers impose separate charges to beneficiaries.
Q:

What can a provider do to minimize missed appointments?

A: These are suggestions only; they do not represent Medicaid policy. It is important to treat all Medicaid beneficiaries in the same manner as other non-Medicaid patients are treated:

• Confirm appointments prior to the date of the appointment by sending a post card or calling
   a day or two before the schedule appointment date or both.
• Inform beneficiaries if they routinely fail to keep an appointment or give advance notice
   when they need to cancel an appointment, you may no longer accept them as a patient.
• Schedule patients to allow for those who are likely to miss a scheduled appointment.
• If a beneficiary misses an appointment, allow him or her to come in as a “walk-in” and wait 
  for a time in the dentist’s schedule to become available.
 


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