UM QuickTips
In every issue of our newsletter, we include utilization management tips that alert you to program information that is important to your office. Please read below for this helpful information. Prior Authorization of D8660We would like to bring to your attention the types of documentation you need to include with a pre-authorization request for CDT code D8660, Pre-orthodontic treatment visit, when you submit it on behalf of a child receiving dental benefits through the Managed Medical Assistance (MMA) Program. In order to provide the appropriate clinical review of your request, MCNA must receive both a narrative and panoramic film. Please ensure the panoramic film submitted is labeled with the member's name and the date it was taken. Please don't hesitate to contact our Provider Hotline at 1-855-698-6262 if you have a question regarding the information provided above. We are here to help!
Utilization Management
In every issue of our newsletter, we include utilization management tips that alert you to program information that is important to your office. Please read below for this helpful information. Prior Authorization of D8660We would like to bring to your attention the types of documentation you need to include with a pre-authorization request for CDT code D8660, Pre-orthodontic treatment visit, when you submit it on behalf of a child receiving dental benefits through the Managed Medical Assistance (MMA) Program. In order to provide the appropriate clinical review of your request, MCNA must receive both a narrative and panoramic film. Please ensure the panoramic film submitted is labeled with the member's name and the date it was taken. Please don't hesitate to contact our Provider Hotline at 1-855-698-6262 if you have a question regarding the information provided above. We are here to help! |
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In the Words of Our Providers...
One of our most important goals is to provide consistently excellent service for our network of quality dental providers. As a company founded and run by dentists, MCNA implicitly understands the challenges associated with the administration of a practice. We are here to help you continue to provide the high quality dental care and services our members depend upon for good oral health! We value the strength of our relationships with network providers, and we love to hear from you! This month, we would like to...
Quality Improvement
One of our most important goals is to provide consistently excellent service for our network of quality dental providers. As a company founded and run by dentists, MCNA implicitly understands the challenges associated with the administration of a practice. We are here to help you continue to provide the high quality dental care and services our members depend upon for good oral health! We value the strength of our relationships with network providers, and we love to hear from you! This month, we would like to... |
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Medicaid Program Integrity: Explore New Educational Materials from CMS
Help the Centers for Medicare & Medicaid Services (CMS) protect program resources and taxpayer dollars by joining in the fight against fraud, waste and abuse! The CMS has designed a new toolkit and organized other new materials to help Medicaid providers get involved. Visit the CMS website today to explore the Medicaid Compliance for the Dental Professional materials. These include a...
MCNA Updates
Help the Centers for Medicare & Medicaid Services (CMS) protect program resources and taxpayer dollars by joining in the fight against fraud, waste and abuse! The CMS has designed a new toolkit and organized other new materials to help Medicaid providers get involved. Visit the CMS website today to explore the Medicaid Compliance for the Dental Professional materials. These include a... |
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Important Change in Background Screening Process for Florida Medicaid
MCNA would like to remind you of the recent change to the background screening process for new and renewing Florida Medicaid providers that took effect March 1, 2015. All background screening is now completed through the Care Provider Background Screening Clearinghouse. The Clearinghouse provides a single data source for screening results and allows for these results to be shared among specified agencies when a person has applied to volunteer, be employed, be licensed, or enter into a contract that requires a state and national fingerprint-based criminal history check. A new Florida Medicaid Originating Agency Identifier (ORI) also took effect on March 1, invalidating the...
MCNA Updates
MCNA would like to remind you of the recent change to the background screening process for new and renewing Florida Medicaid providers that took effect March 1, 2015. All background screening is now completed through the Care Provider Background Screening Clearinghouse. The Clearinghouse provides a single data source for screening results and allows for these results to be shared among specified agencies when a person has applied to volunteer, be employed, be licensed, or enter into a contract that requires a state and national fingerprint-based criminal history check. A new Florida Medicaid Originating Agency Identifier (ORI) also took effect on March 1, invalidating the... |
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Introducing the Claims Reconsideration Unit
The Claims Reconsideration Unit (CRU) provides you with an opportunity to resolve claims payment issues that don't relate to medical necessity or benefit coverage. The CRU evaluates each request and alerts MCNA's Provider Relations team to any identified trends so that our provider communications and training opportunities can be enhanced to reduce claims payment issues. The CRU was developed as part of MCNA's ongoing efforts to improve service quality for providers. Please note that if you file an appeal and MCNA determines that it actually qualifies as a reconsideration request, we will reroute it to the CRU for you. If you receive notification from MCNA that a claim has been denied, you may file a request for a claim to be reconsidered. The timeframe for filing a reconsideration under the Florida Healthy Kids and Managed Medical Assistance (MMA) programs is...
MCNA Updates
The Claims Reconsideration Unit (CRU) provides you with an opportunity to resolve claims payment issues that don't relate to medical necessity or benefit coverage. The CRU evaluates each request and alerts MCNA's Provider Relations team to any identified trends so that our provider communications and training opportunities can be enhanced to reduce claims payment issues. The CRU was developed as part of MCNA's ongoing efforts to improve service quality for providers. Please note that if you file an appeal and MCNA determines that it actually qualifies as a reconsideration request, we will reroute it to the CRU for you. If you receive notification from MCNA that a claim has been denied, you may file a request for a claim to be reconsidered. The timeframe for filing a reconsideration under the Florida Healthy Kids and Managed Medical Assistance (MMA) programs is... |
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"Going Green" with the American Association of Dental Office Managers
The American Association of Dental Office Managers (AADOM) wants your office to go green! The AADOM supports the establishment of "green dentistry" in dental offices across...
Your Practice
The American Association of Dental Office Managers (AADOM) wants your office to go green! The AADOM supports the establishment of "green dentistry" in dental offices across... |
Active Kids, Healthy Teeth
Do your patients and their parents know what to do if a tooth gets chipped or knocked out during the course of play or sports? The American Academy of Pediatric Dentistry (AAPD) has developed a great visual guide to illustrate the steps to take if a child suffers an injury to a...
Children's Corner
Do your patients and their parents know what to do if a tooth gets chipped or knocked out during the course of play or sports? The American Academy of Pediatric Dentistry (AAPD) has developed a great visual guide to illustrate the steps to take if a child suffers an injury to a... |
