- Florida Medicaid Dental Plan Continuity of Care
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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. The transition will occur by Region in 3 Phases, beginning with Regions 9 through 11 on December 1st:
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. Once on the page, click Program Changes, then the Outreach and Presentations link.
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
Click here to access LIBERTY’s Provider Training site.
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.Enrollee Grievance & Appeals Form
FL Medicaid Provider Complaint Form
FL Medicaid Provider Appeal Form
Submit Grievance or Appeal Online
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).
Report Fraud, Waste and Abuse
Fraud, Waste and Abuse Hotline: (888) 704-9833Click here to submit an inquiry related to Security, Privacy, HIPAA, Compliance, or Fraud, Waste and Abuse concerns.
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