MCNA Dental
Dental Details  •  Monthly Provider Newsletter
Texas Edition  •  April 2022
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1-855-776-6262
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Managed Care of North America
200 West Cypress Creek Road, #500
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HHSC Provider Webinar: External Medical Review
HHSC Provider Webinar: External Medical Review

The Texas Health and Human Services Commission (HHSC) has released a new training presentation to assist providers in understanding their role/responsibilities related to the External Medical Review process. Your office may access this important webinar at https://register.gotowebinar.com/recording/4623254401546558726.

MCNA Updates
HHSC Provider Webinar: External Medical Review

The Texas Health and Human Services Commission (HHSC) has released a new training presentation to assist providers in understanding their role/responsibilities related to the External Medical Review process. Your office may access this important webinar at https://register.gotowebinar.com/recording/4623254401546558726.

Member Rights and Responsibilities
Member Rights and Responsibilities

MCNA is committed to providing high-quality dental care to Medicaid and CHIP enrollees across the country. Our mission is to provide access to oral health care and service excellence that improves the oral health outcomes of our members. The satisfaction of our members is a top priority; therefore, we strive to honor their rights. All MCNA members have well-defined rights and responsibilities under the Medicaid Program. As our partner in the ...

MCNA Updates
Member Rights and Responsibilities

MCNA is committed to providing high-quality dental care to Medicaid and CHIP enrollees across the country. Our mission is to provide access to oral health care and service excellence that improves the oral health outcomes of our members. The satisfaction of our members is a top priority; therefore, we strive to honor their rights. All MCNA members have well-defined rights and responsibilities under the Medicaid Program. As our partner in the ...

Medicaid Compliance for the Dental Professional
Medicaid Compliance for the Dental Professional

The Centers for Medicare & Medicaid Services (CMS) offers dental practices resources and guides to help you with the unique challenges you face regarding Medicaid compliance. These resources cover information about documentation expectations, how to use dental software as a tool for good documentation practices, and other recommendations. We encourage you to access and download these helpful tools from the CMS website.

Your Practice
Medicaid Compliance for the Dental Professional

The Centers for Medicare & Medicaid Services (CMS) offers dental practices resources and guides to help you with the unique challenges you face regarding Medicaid compliance. These resources cover information about documentation expectations, how to use dental software as a tool for good documentation practices, and other recommendations. We encourage you to access and download these helpful tools from the CMS website.

OIG Self-Audit Process
OIG Self-Audit Process

The Office of the Inspector General (OIG) recently shared that more Texas Health and Human Services (HHSC) program providers are participating the OIG self-audit process to determine if they need to self-disclose overpayments. The OIG views the program as a way to develop partnerships with providers, allowing the state to reduce fraud, waste, and abuse while offering an opportunity for providers to reduce their legal and financial exposure. Working with the OIG may also lead to a better understanding of the OIG's audit and investigatory processes.

You can learn more about the process and its associated benefits on the OIG's website, including how to self-report and additional information and tools.

Your Practice
OIG Self-Audit Process

The Office of the Inspector General (OIG) recently shared that more Texas Health and Human Services (HHSC) program providers are participating the OIG self-audit process to determine if they need to self-disclose overpayments. The OIG views the program as a way to develop partnerships with providers, allowing the state to reduce fraud, waste, and abuse while offering an opportunity for providers to reduce their legal and financial exposure. Working with the OIG may also lead to a better understanding of the OIG's audit and investigatory processes.

You can learn more about the process and its associated benefits on the OIG's website, including how to self-report and additional information and tools.

After Hours Standards
After Hours Standards

MCNA works closely with our participating providers to ensure that our members have access to the high-quality dental care and services that our members deserve. As part of the role and responsibility of a network provider, your office is required to meet specific after hours standards to ensure that members and their families can remain in communication and access help outside of normal business hours.

All providers offices must maintain an answering service or answering machine that offers the...

Communication
After Hours Standards

MCNA works closely with our participating providers to ensure that our members have access to the high-quality dental care and services that our members deserve. As part of the role and responsibility of a network provider, your office is required to meet specific after hours standards to ensure that members and their families can remain in communication and access help outside of normal business hours.

All providers offices must maintain an answering service or answering machine that offers the...

Informed Consent Requirements
Informed Consent Requirements

Providers must understand and comply with applicable legal requirements regarding informed consent from members, as well as adhere to the policies of the dental community in which they practice. Part of your role as an MCNA network provider is to ensure that each member receives adequate information about any proposed treatment and to be reasonably sure the member has understood it before proceeding. Consent documents should ...

MCNA Updates
Informed Consent Requirements

Providers must understand and comply with applicable legal requirements regarding informed consent from members, as well as adhere to the policies of the dental community in which they practice. Part of your role as an MCNA network provider is to ensure that each member receives adequate information about any proposed treatment and to be reasonably sure the member has understood it before proceeding. Consent documents should ...

National Foster Care Month - May
National Foster Care Month - May

National Foster Care Month recognizes the importance of the foster parents and the entire network of groups and organizations that help to ensure a safe environment for children and youth who temporarily cannot live with their families. If you know a foster family, please take some time to reach out to them and thank them for helping the kids they care for grow and thrive. Foster care is an invaluable resource for keeping children and young people safe when they need it most and providing a critical place of refuge.

Upcoming Events
National Foster Care Month - May

National Foster Care Month recognizes the importance of the foster parents and the entire network of groups and organizations that help to ensure a safe environment for children and youth who temporarily cannot live with their families. If you know a foster family, please take some time to reach out to them and thank them for helping the kids they care for grow and thrive. Foster care is an invaluable resource for keeping children and young people safe when they need it most and providing a critical place of refuge.

Memorial Day - Monday, May 30
Memorial Day - Monday, May 30

Memorial Day, first known as Decoration Day, originated in the years following the Civil War and became a federal holiday in 1971. In the Civil War, which ended in the spring of 1865, more lives were lost than any other conflict in the U.S. history. This required the establishment of the first national cemeteries. By the ...

Upcoming Events
Memorial Day - Monday, May 30

Memorial Day, first known as Decoration Day, originated in the years following the Civil War and became a federal holiday in 1971. In the Civil War, which ended in the spring of 1865, more lives were lost than any other conflict in the U.S. history. This required the establishment of the first national cemeteries. By the ...