Thank you for your interest in accurately coding claims for dental Medicaid patients. This session walks you through the Medical Eligibility codes needed for qualifying patients, and the proper way to submit their claims for timely payment.
Here is the Full Session Recording:
Here are the Presentation Slides:
Need to Know:
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Perhaps you have a few questions. Take a look at some that were commonly asked below. If your question isn't answered here, we're happy to help. Please email Jessica Emmerich and she will respond with the appropriate resources.
What Are My Options for Reimbursement for a Periodic Dental Exam for Patients Over 21 Years of Age?
If your adult patient has limited Medicaid coverage, you can use the procedure code 'D0140' - Limited oral evaluation – problem focused once every two years as long as it's problem-focused. You also have the option of using procedure code 'D0150' - Comprehensive oral evaluation once every three years for the patient.
Using either of these procedure codes allows you to establish care with the patient and gives you the option to bill for recommended procedures as a result of the evaluation.
If a Provider Sees a Patient with a Managed Care Plan, Can They Bill MO HealthNet for the Service?
No, if a participant is enrolled with a Managed Care plan the provider must bill that plan. If the provider is not credentialed with that plan, they should let the participant know.
If a Provider Has Questions About Why a Claim Was Denied, Who Should They Contact?
For questions about why a claim was denied or to check on Prior Authorization status, providers should contact Provider Communications through eMOMED at 573-751-2896. If they are unable to resolve the issue, the provider should then reach out to Provider Education at 573-751-6683.