The Health Care Authority (HCA) recently sent the following alert to dental Medicaid providers.
Attention Dental providers:
The Health Care Authority (HCA) is experiencing an increase in service limit requests for dental-related services through the online webform. As a result, HCA’s responses may take longer than the usual 48 hours.
To streamline the process and help HCA expedite the requests, HCA is asking providers to do the following before submitting client limit inquiries:
- Check client eligibility and confirm enrollment in Apple Health/Medicaid
- Confirm the client’s benefit service package covers the requested service
- Review the appropriate dental billing guide to confirm that:
- The service has limitations
- The service is covered for the client’s age
- Do not send duplicate limit inquiry requests
- Do not send requests by template. Request only the services that will be performed. Requests submitted by template will not be processed.
Associated guides for dental-related services can be found on the Provider billing guides and fee schedules webpage.
- Dental-Related Services
- Access to Baby and Child Dentistry (ABCD)
- Orthodontic Services
- Oral Health Connections