04/22/2014

Tips for dentists handling return of Adult Denti-Cal


May 1 marks the date of formal restoration of adult benefits in the Denti-Cal program. 

Here are a few suggestions for dentists to help make sure they are prepared for the return of Adult Denti-Cal:

Familiarize yourself with the benefits available to adults. The scope of the Denti-Cal program for adult beneficiaries has changed since the program ended in 2009. The return of adult services is not a full restoration of all previously covered services. The restored program emphasizes preventive services, basic restorative procedures, endodontic therapy for anterior teeth, and return to function through the provision of some prosthodontic services. For a listing of all of the specific dental procedures being restored for adults, refer to the Denti-Cal Bulletin, Volume 29, Number 13, from August 2013 (available at denti-cal.ca.gov).

Confirm that you are an enrolled provider in the Denti-Cal program.  The Department of Health Care Services has placed a form on the Denti-Cal website where dentists can confirm their status with the program.  To access this online confirmation of status with the Denti-Cal program, go to denti-cal.ca.gov, select the “Providers” tab at the top of the webpage, then select the link to the “Denti-Cal Provider Enrollment Status FAQ” at the top of the next page, and then select the “Provider Enrollment Status Inquiry form” link. If you are not an enrolled provider, you will not be paid for any services rendered. 

Dentists attending CDA Presents the Art and Science of Dentistry in Anaheim in May, can learn more at the lecture, Adult Denti-Cal Services: Navigating the Renewed Program from 8 to 11 a.m. on Friday, May 16. The lecture will review the scope of benefits of the revived adult program, including administrative requirements of the Denti-Cal program associated with treatment authorizations and documentation required when filing claims.