2015 Dental 2015 Dental Provider Checklist Provider Checklist

20152015

Amy ReyesAmy Reyes

Dental SupervisorDental Supervisor

Direct extension 307-772-8421Direct extension 307-772-8421

Dental Services 1-888-863-5806 Mon-Fri 9-Dental Services 1-888-863-5806 Mon-Fri 9-55Amy.reyes@xerox.com

Information Information

Dental Provider Dental Provider ManualManual

Chapter 1Chapter 1

Chapters 2, 3, and 4 Chapters 2, 3, and 4

Chapters 5, 6, and 7 Chapters 5, 6, and 7

Chapters 8 and 9 Chapters 8 and 9

Chapter 10Chapter 10

Chapter 11 Chapter 11

*Dental fee schedule*Dental fee schedule*Billing deliverables*Billing deliverables*Web portal billing*Web portal billing*ADA dental claim form*ADA dental claim form*TPL keying*TPL keying*CMS re-enrollment*CMS re-enrollment*D9630 and D9920 *D9630 and D9920 *Checking eligibility*Checking eligibility*RA banners*RA banners*Treating and group NPI numbers*Treating and group NPI numbers*Usual and customary charges*Usual and customary charges*Remarks on the claim form *Remarks on the claim form

Agenda Agenda

Dental fee scheduleDental fee schedulehttp://wymedicaid.acs-inc.com/Dental.html

Billing of deliverables Billing of deliverables

Billing of Deliverables All dental procedures that involve delivering an item to the client can only be billed to Medicaid on the date the item is delivered to the client. This includes crowns, bridges, removable appliances, partial and complete dentures. The provider is responsible for billing these procedures only on the seat/delivery date. If a client becomes ineligible before the seat/delivery date or does not return for the seat/delivery, the provider may request, in writing, to bill the procedure out on the prep date. The provider may bill on the prep date only if they have received an approval from Wyoming Medicaid. Please send these requests to the fiscal agent for Wyoming Medicaid (Section 2.1, Quick Address and Telephone Reference). Medicaid may request records to substantiate this is being billed correctly at any time therefore client records should reflect prep and seat dates accurately.

Web portal billing Web portal billing https://wymedicaid.acs-inc.com/wy/general/home

ADA Dental Claim ADA Dental Claim formform

TPL information on the TPL information on the claim form claim form

CMS re-enrollment CMS re-enrollment http://wymedicaid.acs-inc.com/aca_reenrollment.html

D9630 Other Drugs D9630 Other Drugs and Medicaments and Medicaments

D9920 Behavior D9920 Behavior ManagementManagement

Verifying Eligibility Verifying Eligibility prior to services prior to services rendered rendered

Importance of Reading Importance of Reading RA Banners RA Banners

Treating VS Group NPI Treating VS Group NPI

Usual and Customary Usual and Customary ChargesCharges

Remarks Box on Claim Remarks Box on Claim Form. Do not use. Form. Do not use.

Questions? Questions?