MCNA Dental
Dental Details  •  Monthly Provider Newsletter
Texas Edition  •  March 2022
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Access and Availability Requirements for Medicaid Members
Access and Availability Requirements for Medicaid Members

As a Medicaid-participating provider, your office is required to ensure that all of the Medicaid enrollees you treat have access to the same appointment availability as all other patients. Appropriate access to care is an essential part of MCNA's Quality Improvement Program. Access to care is monitored by the Provider Relations (PR) Department. Periodically, one of our PR Representatives may reach out to your office via a written ...

Quality Improvement
Access and Availability Requirements for Medicaid Members

As a Medicaid-participating provider, your office is required to ensure that all of the Medicaid enrollees you treat have access to the same appointment availability as all other patients. Appropriate access to care is an essential part of MCNA's Quality Improvement Program. Access to care is monitored by the Provider Relations (PR) Department. Periodically, one of our PR Representatives may reach out to your office via a written inquiry or phone call to obtain information concerning the next available appointment.

Any dental provider who serves MCNA members, including a provider who delivers services at locations other than his or her physical office location, such as school based or mobile dental services, must be able to demonstrate to the satisfaction of MCNA that he or she has the requisite skill and facilities to deliver comprehensive care to MCNA members. Comprehensive care means that the provider or group must provide all of the covered restorative and therapeutic services described in the MCNA Provider Manual, which also contains more information including missed appointments, after-hours standards, and appointment availability standards.

We strongly encourage you to review the Access Requirements section in MCNA's Provider Manual, which is always available to download from our Provider Portal or website. If you have questions, please call MCNA's Provider Hotline at 1-855-776-6262 (8 a.m. to 7 p.m., Central Time, Monday through Friday).