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Florida Medicaid Dental Plan Continuity of Care

The Agency for Health Care Administration (Agency) contracts with Medicaid Dental Plans to provide dental services to dental plan enrollees in the Statewide Medicaid Managed Care (SMMC) program. The Agency recently entered into a contract with LIBERTY Dental Plan (LIBERTY) as one of three statewide Medicaid Dental Plans.

LIBERTY Dental Plan is required to ensure continuity of care (COC) during the transition period for Medicaid recipients enrolled in the SMMC program.

COC requirements ensure that when enrollees transition from one health or dental plan to another, one service provider to another, or one service delivery system to another (i.e., fee-for-service to managed care), their services continue seamlessly throughout their transition. The Agency has instituted the following COC provisions under its contract with LIBERTY:

  • Dental providers should not cancel appointments with current patients. For 120 days after the roll-out date in each region, LIBERTY must honor any ongoing treatment that was authorized prior to patient’s enrollment into LIBERTY as their Dental Plan.
  • Providers will be paid. Providers should continue providing any services that were previously authorized, regardless of whether the provider is participating in LIBERTY’s network. LIBERTY must pay for previously authorized services for up to 60 days after the roll-out date in each region, and must pay providers at the rate previously received for up to 30 days.
  • Providers will be paid promptly. During the continuity of care period, LIBERTY is required to follow all timely claims payment contractual requirements. The Agency will monitor complaints to ensure that any issues with delays in payment are resolved.

More information about COC provisions can be referenced on the COC program highlight document, which is posted on the Agency’s website at www.ahca.myflorida.com/smmc Link Icon . Once on the page, click Program Changes, then the Outreach and Presentations link.

Member Dental Home Assignments

LIBERTY Dental Plan is temporarily removing the requirement of Member Dental Home Assignment.

Effective immediately your office will only need to verify Eligibility prior to scheduling and treating our Medicaid enrollees. The enrollee does not need to appear on your roster in order to be seen. Additionally, based on claims received LIBERTY will transfer your patients to your office for you.

Members DO NOT need to call to transfer, if they require a transfer they can complete the transfer on our website.

Please refer to the provider alert Florida Medicaid Dental Home Assignment Relief sent on 1-23-2019 and posted on your secure provider portal for waiver period in your Region.

Provider Alerts

ATTN: All LIBERTY Dental Plan Network Providers
Please notify LIBERTY Dental Plan immediately if you anticipate or experience any disruption to your practice related to COVID-19. If your office temporarily closes during regular business hours, please ensure that patients are connected to a staff member so that their concerns are triaged appropriately. Additionally, please ensure that your after-hour phone messaging advises patients when you expect to reopen and how they can access emergency care.

We continue to monitor the coronavirus and its impact on our network dental practices and members’ ability to access care. We have taken steps to protect our staff including pausing office visits, but are committed to providing you with necessary support during this time. Our Provider Relations, Call Center, Claims, and Utilization Management Departments remain operational.

Coronavirus Resources for Dental Providers

Coronavirus (COVID-19) - American Dental Association Information Handout
On February 24, 2020, the American Dental Association (ADA) released an informational handout for dentists on the coronavirus disease, now named COVID-19 which . This handout covers strategies for helping to avoid the spread of suspected respiratory disease in the dental health care setting. It also answers commonly asked questions related to the virus. All the information is based on advice from the Centers for Disease Control and Prevention.

The ADA recommends that:

  • Dental staff be alert and patients with a serious respiratory illness when they arrive. Staff should give them a one-use surgical face mask to wear. Patient must be isolated in a single-patient room with the door kept closed. This is important to limit their contact with other patients and staff. Isolated patients should wear their face masks outside their rooms.
  • Dental practices strictly follow respiratory hygiene/cough etiquette infection control measures.This includes performing hand hygiene, providing tissues, and no-touch containers to throw away used tissues. Dental offices should also offer face masks to patients who are coughing. Dental practices should make sure to follow routine cleaning and disinfection approaches used during flu season.
  • Dental staff assessing a patient with a flu-like or other respiratory illness need to act immediately. All staff should wear a disposable surgical face mask, nonsterile gloves, gown and eye protection to prevent contact with such patients. Because recommendations for COVID-19 could change as more information becomes available about the disease, the ADA suggests checking for updates on the CDC's coronavirus infection control page for health care professionals.
  • In addition, the CDC recommends all health care workers, including dentists and staff, receive the flu vaccine. Staff going through a flu-like illness should not report to work at all. Please inform LIBERTY Dental Plan instantly if you expect or are going through any disruption to your practice related to the current coronavirus outbreak.

SMMC Provider Webinar Training

CMS Training Requirements

All LIBERTY Dental participating providers are required to complete the following training modules each calendar year:

  • Critical Incident Training
  • Code of Business Ethics & Conduct
  • Cultural Competency Provider Training
  • Fraud, Waste & Abuse Training
  • General Compliance Training

Access LIBERTY’s Provider Training site. Link Icon

File a Grievance or Appeal

To submit a written Grievance or Appeal, please use the link below to print and mail to LIBERTY Dental Plan, or complete the online form below.

Language Assistance

This information is available for free in other formats. Please contact our customer service number at 1-833-276-0850 or TTY 1-877-855-8039 Monday through Friday from 8:00 a.m. to 8:00 p.m. (ET).

How do I report Fraud, Waste and Abuse?

To report possible unethical business practices or potential illegal activity regarding our health Plan, our providers, vendors, or recipients, you may contact LIBERTY:

Compliance Hotline: (888) 704-9833

Submit a FWA concern online Link Icon

E-mail: compliance@libertydentalplan.com

Mail: LIBERTY Dental Plan Compliance Department

  • P.O. Box 15149
  • Tampa, FL 33684

You may remain anonymous if you prefer. All information received or will be treated as confidential, and the results of investigations will be discussed only with persons having a legitimate reason to receive the information.

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