Making members shine, one smile at a timeTM
LIBERTY Dental Plan of Nevada
Medicaid Program
Provider Frequently Asked Questions
www.libertydentalplan.com |
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© 2018 LIBERTY Dental Plan of California, Inc. |
Making members shine, one smile at a timeTM
LIBERTY Dental Plan of Nevada
Medicaid Program
Provider Frequently Asked Questions
www.libertydentalplan.com |
Page 1 of 4 |
|
© 2018 LIBERTY Dental Plan of California, Inc. |
Making members shine, one smile at a timeTM
Provider Frequently Asked Questions - FAQs
Q:When will the Nevada Medicaid dental benefits transition to LIBERTY Dental Plan of Nevada?
A:LIBERTY Dental Plan of Nevada (LIBERTY) will be the new Dental Benefits Administrator effective January 1, 2018 to serve members enrolled in a Managed Care Organization (MCO) in Washoe and Clark counties.
Q: Where do I submit claims for Nevada Medicaid members after January 1, 2018?
A:All dental claims for managed care members for dates of service on or after January 1, 2018, should be sent to LIBERTY electronically via EDI (Payor ID is CX083), LIBERTY’s web portal at:
www.libertydentalplan.com/NVMedicaid or you can send them directly to:
LIBERTY Dental Plan of Nevada
PO Box 401086
Las Vegas, NV 89140
Claims submitted to
All dental claims for managed care members for dates of services between July 1, 2017 and December 31, 2017, should be sent to
Service (FFS) Nevada Medicaid.
Q: Does LIBERTY accept NEA FastAttach?
A:Yes, LIBERTY accepts NEA FastAttach. Below is the contact information:
National Electronic Attachment, Inc.
(800)
Q:Will LIBERTY honor services previously approved for Nevada Medicaid members?
A:LIBERTY will ensure continuity of care for Nevada Medicaid members and will honor prior authorizations for services approved by the previous carrier for up to 120 days following the January 1, 2018 effective date with LIBERTY.
Q:Who is responsible for any Nevada Medicaid member’s unpaid claims for dates of service prior to the January 1, 2018 roll out?
A:The former dental carrier is responsible to pay claims for any treatment rendered prior to the January 1, 2018 effective date with LIBERTY.
Q: Are referrals for specialty care required?
A:Yes. Specialty care referrals are required for endodontists, oral surgeons or periodontists.
Q: When is prior authorization necessary?
A:Prior authorization applies to general dentists and specialists for certain covered procedures. Please refer to the Nevada Medicaid benefit schedule for services that require prior authorization.
www.libertydentalplan.com |
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© 2018 LIBERTY Dental Plan of California, Inc. |
Making members shine, one smile at a timeTM
Q:Is prior authorization required for a general dentist to refer a member for an orthodontic evaluation?
A:In all areas of Nevada, orthodontic coverage is provided through the Fee for Service (FFS) benefit plan and requires a dentist’s referral. Prior authorization requests and claims for orthodontics must be submitted to Nevada Medicaid, not LIBERTY.
Q: Does the member ID card guarantee eligibility?
A:No. You must verify eligibility for each member prior to their appointment. Real time eligibility can be verified through LIBERTY at the following link:
Visiting the Provider Portal at: www.libertydentalplan.com/NVMedicaid
Sample of the ID card
LIBERTY Dental Plan of Nevada
www.libertydentalplan.com/NVMedicaid
(866)
|
NAME First Name, Last Name |
ID# Medicaid ID# |
EFFEC 01/01/2018 |
GRP# [001234] Group Name
PLAN Nevada Medicaid Dental
PRV# [001234] Dental Home Name
Dental Home Address
City, State, Zip Code
TEL#
STATE OF NEVADA MEDICAID TEL#
NOTICE TO MEMBER
If you have a dental emergency, you should first contact your Primary Care Dentist for an immediate appointment. If your Primary Care Dentist is not available, contact LIBERTY Dental Plan Member Services for assistance. Please refer to your Member Handbook for specific emergency care coverage.
EDI Payer ID: CX083
Member Service Grievance & Appeals (866)
Normal Business Hours
THIS CARD DOES NOT GUARANTEE ELIGIBILITY
Q:What is LIBERTY’s turnaround time for prior authorization and claims processing?
A:Our average turnaround times are:
•Prior authorizations – 5 business days of receipt.
•Clean electronic claims – 15 business days
•Clean paper claims – 20 business days
Q: What is the claim filing deadline?
A:Claims may be submitted for payment up to 180 days following the date of service for in- state providers.
Q:What if my patient is the beneficiary or member of more than one plan? How is Coordination of Benefits handled for the Nevada Medicaid program?
A:The Provider Reference Guide contains detailed information about how Coordination of Benefits occurs when one of the plans is Nevada Medicaid. In general, Nevada Medicaid is the payer of last resort and is secondary to most other plans.
www.libertydentalplan.com |
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© 2018 LIBERTY Dental Plan of California, Inc. |
Making members shine, one smile at a timeTM
Q: How can I sign up for LIBERTY’s Provider Portal?
A:Please visit: www.libertydentalplan.com/NVMedicaid to register as a new user. Your office’s “Access Code” and “Office Number” will be required to register and are included in your LIBERTY Welcome letter.
Please contact LIBERTY’s online administrator at 1.888.700.0643 or send an
Q:How do I obtain LIBERTY’s Benefit Plans?
A:You may obtain a copy by logging in to LIBERTY’s secure provider portal at: www.libertydentalplan.com/NVMedicaid
Q:Does LIBERTY pay on prep date or delivery date?
A:Claims should be submitted reflecting the delivery date of fixed and/or removable appliances.
Q: Does LIBERTY offer training for dental providers?
A:Yes, we offer providers training during orientation; in addition, training documents can be referenced on our website at: www.libertydentalplan.com/NVMedicaid
Q:How do I receive electronic claims payment?
A:LIBERTY encourages providers to sign up for EFT (direct deposit) so that you receive your payments faster. The EFT form can be obtained on our website at: www.libertydentalplan.com/NVMedicaid
Q:Will providers have access to claims history for Nevada Medicaid members?
A:Yes.
Q: How can I obtain a copy of an eligibility roster?
A:You can verify
Q:Does a member have to appear on my roster in order to be eligible to receive treatment?
A:Yes. Your office can verify
www.libertydentalplan.com |
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© 2018 LIBERTY Dental Plan of California, Inc. |