Fw: [thearcCA] Dental Coverage [1 Attachment]

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HCDD INC.

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Nov 9, 2011, 5:11:31 PM11/9/11

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----- Forwarded Message ----
From: joyce hearn <jhear...@yahoo.com>
Sent: Wed, November 9, 2011 11:10:05 AM
Subject: Fw: [thearcCA] Dental Coverage [1 Attachment]

----- Forwarded Message -----
From: Tony Anderson <to...@thearcca.org>
To: "thea...@yahoogroups.com" <thea...@yahoogroups.com>
Sent: Wednesday, November 9, 2011 9:41 AM
Subject: [thearcCA] Dental Coverage [1 Attachment]

[Attachment(s) from Tony Anderson included below]

Check this out. It's an advisory announcement to Denti-Cal providers and recipients with I/DD stating they will start processing claims on January 13th for adults (children were already covered still because of EPSDT program requirements). I've attached the announcement.

Optional Adult Dental Services for
Department of Developmental Services
(DDS) Regional Center Consumers Restored
Effective January 13, 2012, the Medi-Cal Dental Program (Denti-Cal) will begin processing
dental claims for regional center consumers (also known as DDS beneficiaries or consumers of
DDS) age 21 and over, who have Medi-Cal and do not reside in a licensed health facility
(Intermediate Care Facility or Skilled Nursing Facility). Services may be provided effective
January 1, 2012; however providers should not submit claims for regional center consumers to
Denti-Cal until January 13, 2012.

These regional center consumers are eligible for the optional adult dental services eliminated in
2009 and are exempt from the $1,800 annual dental cap. All dental providers providing services
to regional center consumers must be enrolled in the Denti-Cal program.

Claims for regional center consumers will be authorized in accordance with existing Denti-Cal
policies, procedures, and requirements. Claims will be reimbursed by Denti-Cal at the billed
amount or the current Denti-Cal Schedule of Maximum Allowance rates, whichever is lower.
Providers who submit claims for services to regional center consumers are exempt from the 10%
provider payment reduction. Providers can contact the Denti-Cal Telephone Service Center to
verify beneficiaries who are regional center consumers.

For more information about submitting dental claims for regional center consumers, please
contact Denti-Cal Telephone Service Center at (800) 423-0507.

Note: Non DDS Medi-Cal beneficiaries are still subject to the elimination of optional adult
dental benefits (see the 2009 bulletin Volume 25, Number 22) and the $1,800 annual dental
cap.

Tony Anderson
Executive Director
The Arc California
(916) 552-6619
to...@thearcca.org

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Attachment(s) from Tony Anderson

1 of 1 File(s)