The governor has declared a state of emergency for Hurricane Helene (EO 24-209) and Hurricane Milton (EO 24-215) for the following counties: Alachua, Baker, Bay, Bradford, Brevard, Calhoun, Charlotte, Citrus, Clay, Collier, Columbia, DeSoto, Dixie, Duval, Escambia, Flagler, Franklin, Gadsden, Gilchrist, Glades, Gulf, Hamilton, Hardee, Hendry, Hernando, Highlands, Hillsborough, Holmes, Jackson, Jefferson, Lafayette, Lake, Lee, Leon, Levy, Liberty, Madison, Manatee, Marion, Monroe, Nassau, Okaloosa, Okeechobee, Orange, Osceola, Pasco, Pinellas, Polk, Putnam, Santa Rosa, Sarasota, Seminole, St. Johns, Sumter, Suwannee, Taylor, Union, Volusia, Wakulla, Walton, and Washington counties.
The "Disaster Grace Period" for Hurricane Helene began 9/25/2024 and on 10/7/2024 for Hurricane Milton. and continue until further notice. This provision applies ONLY to the FEMA-designated counties.
Referral, Pre-Authorization Required
- Claims will not be denied due to the lack of referral or pre-authorization on file; these request will be routed to a Dental Consultant for review and determination.
Teledentistry codes D9995 or D9996
- Teledentistry codes D9995 or D9996 will not be denied.
- This includes but is not limited to plans that show this treatment as Non Par or Out of Network.
- These codes will not be denied for any reason other than Duplicate to a previously paid claim.
No out of Network benefits
- We will NOT auto-deny covered services when the provider is OON
-
Claims will be reviewed and if related to emergency/urgent service they will be sent to a Dentist
for review and may be paid.
-
Any claim denying due to OON will be reviewed for emergency/urgent narrative and or codes,
WHEN the code being billed is a “in-network” covered service. This will not apply to non-covered
codes or frequency denials.
-
Emergency/urgent narratives include but are not limited to (pain, swelling, bleeding, broken
or similar)
-
Emergency/urgent codes when covered on their plan include but are not limited to
| D0140 |
D0220 |
D3221 |
D7111-D7250 |
D9110 |
| D0145 |
D0230 |
D3230 |
D7260 |
|
| D0150 |
D0330 |
D3240 |
D7261 |
|
| D0170 |
D2970 |
D3999 |
D7270 |
|
| D0180 |
D3220 |
D4999 |
D7510-D7521 |
|
