How do I request an ID card?

Each covered Recipient will receive a Medicaid identification (ID) card, issued by Nevada Medicaid. In addition, each Recipient will also receive an identification (ID) card from LIBERTY. You are responsible for bringing both ID cards with you to your dental appointments. You may call LIBERTY at 866.609.0418 to ask for a new ID card if you misplace it or need to correct any of the information on the card.

How do I obtain / download a Member Handbook?

Contact Member Services at 866-609-0418 and we will mail one to you. You can also view and print an up to date copy anytime by clicking the links below:

• Member Handbook - English
• Member Handbook - Spanish

Who do I contact if I have questions or need help with my dental benefits?

If you have questions regarding your dental benefits, locating a participating provider, or for assistance obtaining an appointment, please contact LIBERTY’s Member Services Department toll-free at 866.609.0418. Business hours are Monday through Friday 5:00 am to 5:00 pm Pacific Time.

What are my dental benefits with LIBERTY Dental Plan?

The Nevada Medicaid Dental Program covers dental services for eligible Medicaid Recipients:

• Children who are newborns through age 20.
• Children who are under age 19 and qualify for Nevada Check Up.
• Pregnant women who are age 21 or older.
• Adults who are age 21 or older

You can find detailed information about benefits in your Member Handbook.

• Member Handbook - English
• Member Handbook - Spanish

What resources do I have to learn more about good oral health?

LIBERTY Dental Plan is committed to your oral health and believes it is critical to whole body health, especially for children.

Dental visits can provide key diagnostics – identifying diabetes and other chronic diseases – and, taking care of your mouth is one of the best ways to prevent a wide range of health problems.

Your Member Handbook has some important oral health tips and some ailments that are linked to poor oral health - so take care of your pearly whites.

• Member Handbook - English
• Member Handbook - Spanish

Can I get my member materials in another language?

We want to make sure you fully understand your benefits, if English is not your first language; LIBERTY provides interpretation services and translation of certain written materials in your preferred language at no cost to you. To ask for language services call 866.609.0418. If you have a preferred language, please notify us of your personal language needs by calling 866.609.0418.

What should I do if I have a grievance (complaint)?

A grievance is a formal statement expressing dissatisfaction with LIBERTY, a dentist or your dental services. Grievances are not eligible for the Fair Hearing process.

If you have a problem with LIBERTY, a dentist, or with your dental services, you have the right to file a grievance/complaint to your Dental Plan. LIBERTY will review your concern and make every effort to get you an answer within 30 calendar days.

How do I submit a grievance (complaint)?

You may submit your complaint over the phone by calling LIBERTY’s Member Services Department at 1-866-609-0418. You can also send your complaint:

• In writing to:
  • LIBERTY Dental Plan of Nevada, Inc.
  • Grievance and Appeals Department
  • 6385 S. Rainbow Blvd. Suite 200
  • Las Vegas, NV 89118
• By facsimile to: 1-833-250-1814, or
• Through our online grievance filing process

Grievance forms are also available on our website, Members/Forms-Literature , by calling LIBERTY’s Member Services Department or by asking your provider. A grievance form is not required to submit a grievance. LIBERTY will review a grievance submitted in any format.

If someone other than you submits a grievance on your behalf, they must have your written consent.

If you need help filing your complaint, we can help you. We can give you free language services. Please call the Member Services Department at 1-866-609-0418 or TTY/TDD 1-877-855-8039.

What should I do if I want to file an appeal?

If we sent you a Notice of Action (NOA) letter and you do not agree with the outcome, you can file an appeal. Your dentist can file an appeal on your behalf as well. You must complete LIBERTY’s appeals process before you can request a Fair Hearing. You will receive a response within 30 calendar days.

How do I submit an appeal?

You or your dentist, on your behalf, may submit an appeal to LIBERTY. If someone other than you submits an appeal on your behalf, they must have your written consent. All appeals must be submitted within 90 calendar days from the date on the notice you received. Appeals may be submitted verbally or in writing.

We will start working on your verbal appeal the first day that it is received, however, if the appeal is not received in writing LIBERTY will not be able to complete the appeals process. All submitted appeals must be submitted in writing and must include the following:

• Your Medicaid ID number
• Your date of birth
• Your provider’s name
• The date of service
• Your mailing address
• An explanation of why you feel the decision should be reversed
• Any supporting documents or records

If you feel that the standard time frame for an appeal could cause serious harm or jeopardy to your dental health, you may request an expedited (fast) appeal. LIBERTY will not take any actions against you if you request an expedited appeal. LIBERTY will also provide you with the chance to review the case file before and after the processing of your appeal.

Appeals can be sent in writing to one of the following:

• In writing to:
  • LIBERTY Dental Plan of Nevada, Inc.
  • Grievance and Appeals Department
  • 6385 S. Rainbow Blvd, Suite 200
  • Las Vegas, NV 89118
• Facsimile to: 1-833-250-1814, or
• Through our online grievance filing process
• Appeal forms are also available on our website,
  • Members/Forms-Literature , by calling LIBERTY’s Member Services Department or by asking your provider.

What if I am not satisfied with the response to my appeal? If you are not satisfied with the resolution to your appeal, you may contact the Hearings Unit with the Division of Health Care Financing and Policy at 1-775-684-3604 or 1-800-992-0900, extension 43604 to request a Fair Hearing. A copy of the Fair Hearing request form is also included with the Notice of Appeals Resolution letter sent to you.

Fair Hearing

You or your dental provider have the right to ask for a Fair Hearing from the state after you have gone through LIBERTY’s internal appeal process. If someone other than you asks for a Fair Hearing on your behalf, they must have your written consent. If you are not satisfied with the resolution to your Appeal, you may contact the Hearings Unit with the Division of Health Care Financing and Policy at 1-775-684-3604 or 1-800-992-0900, extension 43604.

You can request a Fair Hearing by mail by completing and sending the Fair Hearing request form on page 44 of this member handbook (and attached to your Notice of Appeals Resolution letter) to:

• Nevada Division of Health Care Financing and Policy,
• Hearings Unit
• 4070 Silver Sage Dr
• Carson City, NV 89701

You can also go online to access the recipient Fair Hearings request form at:
http://dhcfp.nv.gov/resources/PI/Hearings/.

You or your dental provider must ask for this hearing within 120 days of receiving the final notice from LIBERTY. You may designate a person to act on your behalf and file a Fair Hearing in writing.

If you need information or help, call the State Medicaid Office at:

• Northern Nevada: 1-775-687-1900 or 1-800-992-0900
• Southern Nevada: 1-702-668-4200 or 1-800-992-0900

If you need legal assistance, call the Nevada Legal Services Program:

• Clark County: 1-702-386-0404 or 1-866-432-0404
• Washoe County: 1-775-284-3491 or 1-800-323-8666

If you need information or help, call us at:

• Toll-Free: 1-866-609-0418
• TTY/TTD: 1-877-855-8039

What do I do if I have other dental insurance coverage?

If you or anyone in your family has other dental insurance, you must tell LIBERTY and your dentist. Any other insurance coverage is considered primary to your coverage with LIBERTY and must be paid first.

You may have other dental insurance through your job or your children may have other dental insurance through another parent. You must tell LIBERTY if you have any other coverage, by calling Member Services at 1-866-609-0418, TTY/TDD 1-877-855-8039. When you visit your Dental Home, you must also let them know about any other insurance coverage. This will help us make sure all your services get paid for.

How do I verify my dental eligibility and enrollment?

If you have questions regarding your dental eligibility or to find out if you are enrolled in dental, please contact LIBERTY’s Member Services Department toll-free at 1-866-609-0418. Business hours are Monday through Friday 5:00 am to 5:00 pm Pacific Time Standard Time.

You are eligible for LIBERTY Dental Plan because you qualify for Medicaid and live in Washoe or Clark County. The Division of Welfare and Supportive Services determines Medicaid and Nevada Check Up eligibility for Nevadans. Online applications can be completed using Access Nevada at www.dwss.nv.gov.

For questions about enrollment or disenrollment you can call the Nevada Medicaid District Office at:

• Northern Nevada: 1-775-687-1900 or 1-800-992-0900
• Southern Nevada: 1-702-668-4200 or 1-800-992-0900

How do I schedule transportation?

Non-Emergency Transportation (NET) is provided to Nevada Medicaid members to get necessary covered services. Nevada Check Up members are not eligible for NET services.

Transportation services are managed through MTM to provide you with non-emergency transportation to your dental appointments. If you have questions or need assistance setting up transportation you may call MTM at 1-844-879-7341, or you may contact LIBERTY’s Member Services at 1-866-609-0418 to help coordinate transportation for you.

You must call at least five working days before your non-urgent appointment to set up transportation. If you have less than 5 days before your appointment you should still call MTM at 1-844-879-7341 for assistance. MTM schedules routine trips Monday through Friday from 7 a.m. to 5 p.m. Pacific Time.

Information needed to set up transportation services:

• The street address, including city and zip code of your pick up and drop off locations, and telephone number.
• If you have a Nevada Medicaid ID number, please have it ready for the reservation specialist

Minors under age 18 must travel with an adult 18-year-old or older. Members 15-17 years of age may travel alone if MTM has an approved Parental Consent Form on file. Minors under age 18 that are legally married, emancipated or obtaining family planning services are able to travel alone.

Transportation is only available when you choose to have services at the nearest appropriate network provider.