Dentists have reported to CDA that pharmacies have rejected their prescriptions due either to forms that are out of date or are missing required elements. All prescriptions have been for controlled substances, which must be on tamper-resistant forms printed by California-approved printers and containing California-specific pre-printed elements.
More than 7 million adults enrolled in Denti-Cal, California’s Medicaid dental program, will have a fully restored package of dental benefits in 2018. The adult benefit package was drastically cut in 2009 due to the state budget crisis and was partially restored in May 2014. The restoration of the adult dental benefit services is a result of legislative action taken during the 2017-18 budget process.
CDA Practice Support occasionally hears a complaint from dental offices that a plan granted a preauthorization for treatment and then denied payment when the claim was submitted. Digging a little deeper into these complaints, there may be some confusion between what constitutes a “preauthorization” and what is a “predetermination” or pre-estimate of benefits.
The ordered closure in mid-December of a children’s dental clinic in Southern California reminds dental practices of the importance of cleaning and maintaining dental unit water lines for the safety of patients. CDA urges dentists to ensure they are following the Dental Board of California’s current requirements along with CDC recommendations.