Or Members will be able to choose from a package of up to nine benefits, which may include benefits such as dental, vision, and hearing flex card healthy food and in-home support. Limitations: Service limitations are covered in Take care of your teeth and gums for a healthy smile. Click on the Find a Doctor Search Tool link below to search for a PCP by name, location or specialty. Understand special oral health concerns during pregnancy, dental benefits for pregnant women and babies, and more. Here's how caregivers can protect oral health. Antimicrobial mouthwash kills bacteria to control or reduce bad breath, gingivitis, plaque and tooth decay. KY Medicaid also uses Current Procedural Terminology (CPT) codes and Healthcare Common Procedure Coding system (HCPCS) codes. The data collected are carefully checked by our experts before they are added to the database. Jimenez understands the importance of delivering excellence, one of DentaQuests five core values, and regularly emphasizes it to his team. View profile & reviews Other providers Availability last updated 07/02/2023 Insurance info unavailable Lawrence Vornholt, DMD 42 mi Dentist 815 Eastern Blvd, Clarksville, IN 47129 The plan covers cleanings, exams, and X-rays at 100% with no waiting period when you visit a dentist in your plans network. Encourage your childs life-long oral health. DentaQuest, one of the nations largest and most experienced Medicaid dental benefits administrators, today announced its new engagement with Partners Health Plan (PHP) to increase access to oral health care and improve outcomes for individuals with intellectual and/or developmental disabilities (I/DD). Enter the name of the PCP you want in the PCP Name field. DentaQuest announced today that Executive Vice President and Chief Human Resources Officer Roxanne Martinez is an inductee to the Association of Latino Professionals For Americas (ALPFA) second annual Most Powerful Latinas (MPL) Hall of Fame. 2021 Anthem Insurance Companies, Inc. Llame a nuestro nmero de Servicio de Atencin al Cliente (TTY: 711). Prior authorization requirements are covered by You can register here. You also must be enrolled in both Medicare Part A and Part B and be at least 65 years old for most plans. Dental Services - PT (60) (61) - Cabinet for Health and Family Services Here, you will find Anthem's provider manuals, Guidelines for clinical Utilization Management (UM) and medical policies. Have you wondered how dental insurance works, what the benefits are, or if its worth having? Providers | Tools, Resources & More | Anthem.com If you need routine eye services, call eyeQuest at 1-855-343-7405. DentaQuest President Steve Pollock presided as master of ceremonies at recent 5-year anniversary breakfast recognizing the organizations efforts to combat the opioid crisis. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Contact will be made by an insurance agent or insurance company. Daily habits can support a baby's oral health even before the first tooth comes in. Anthem members may log into an online portal to find participating dentists, dental offices and more. Find a doctor search tool To find an in-network dentist or change your primary care dentist (PCD), call DentaQuest at 855-343-7405. Policies outlining the basic terms for reimbursement of services covered under our members benefits plans. Each MCO provides prior authorization for itsbeneficiaries. Yet it also would likely not be shocking to most veterans that VA benefits can be inadequate and hard to access. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Find a Doctor. Anthem Blue Cross Blue Shield Dentists Near Me in Lexington, KY - Zocdoc Performance Areas Aetna Better Health of Kentucky Anthem BCBS Humana Reminding members to have important preventive screenings. Provider manuals and quick reference guides Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the . Get the most from your tooth-brushing time. 907 KAR 1:026 Section 15. Dont Miss: Pueblo Dentists That Take Medicaid. As we celebrate Hispanic Heritage Month, we sat down with Dr. Bertha Alarcon, for a conversation about the importance of representation in dentistry. You can also search for doctors who are accepting new patients and can serve as your PCP. Know what these are when choosing a plan. For general questions about enrollment, you can email MPSInquiries@anthem.com. Understand what dental insurance covers so you can choose the plan that's right for you and your family. Filing your claims should be simple. Learn more Eligibility & applying for Medicaid Vaping harms the whole body, including your teeth and gums. Every individual and family has different dental needs. Guard against pain and infection for your child with a couple of small changes. Lori LaPortes personal and professional life has revolved around the issue of substance use disorder. Youll need the member ID number on your ID card to register. DentaQuest Member Services: 855-343-7405. Answers to your medical questions any time, night or day, Get help with mental health or substance abuse crises 24 hours a day, 7 days a week, For information on the Kentucky Medicaid program All about signs, screening and early detection of oral cancer. . Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the Blue Cross and Blue Shield Association. Many people find value in buying dental coverage apart from their medical plan because separate plans usually offer more choices and may have better benefits to meet the needs of your whole family. Avoid cavities by preventing damage to tooth enamel. Log in to your accountto renew your plan or compare options. New department for Medicaid services MAP form available for providers- Cancer Care Navigator- Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines- Medical Policies and Clinical Utilization Management Guidelines update- Specialty pharmacy site of care- Prior authorization updates for medications billed under the medical benefit AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines update- Medical step therapy updates, Dont Miss: Dentist In Lafayette That Accept Medicaid. It requires a prescription. Separate or stand-alone dental plans cover routine preventive care to complex procedures like root canals. Instructions, MAP-9A - Kentucky Medicaid Program Orthodontic Services Agreement, MAP-306 - Temporomandibular Joint (TMJ) Assessment Form, MAP-396 - Kentucky Medicaid Program Orthodontic Evaluation Form, MAP-559 - Six Month Orthodontic Progress Report, MAP-700 - Kentucky Medicaid Program Orthodontic Final Case Submission. If you have a CAQH user ID, please make sure to give Anthem authorization to view your CAQH credentialing information. Contact Us | KY Provider - Anthem You May Like: Can I Check Medicaid Status Online. Your dental providerhas a list of what specific services are covered. We welcome Medicaid & most insurance plans at our dental offices. That's why Anthem Blue Cross and Blue Shield Medicaid (Anthem) uses Availity, a secure and full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Gain insight on work/balance, relationship-building, and accountability from Cheryl Polmatier, AVP at DentaQuest and advisory board member of Women in DSO. Visit any dentist you prefer or pay less when you choose a dentist from our extensive dental Preferred Provider Organization (PPO) network. Partner Portal Provider Directory - Kentucky Behavioral Health Provider Resources As the nation's second largest health plan-owned company, Anthem Behavioral Health provides choice, innovation and access. Investment fills gap in access to preventive and restorative dental care for individuals in need. We offer dental services including: You May Like: Choose A Health Plan Medicaid. The number is also on the back of your ID card. See our Medicare enrollment guide for more information about eligibility and enrollment dates. If you cant find your insurer on our site, give us a call at 262-965-3662. For dental coverage through a Medicare Advantage plan, you must enroll during certain times of the year such as when you first become eligible for Original Medicare or during the Annual Enrollment Period that takes place each fall. Enroll in a stand-alone dental insurance plan anytime during the year or add it to one of Anthemshealth insuranceorvision insuranceplans. Dont Miss: Dental Care That Accepts Medicaid. April is Minority Health Month, making today an opportune time for all of us to recognize progress toward reducing maternal mortality. That goes double for dental plans for veterans. Claims must be received within 12 months ofthe date of serviceor six months from the Medicare pay date whichever is longer, or within 12 months ofthe last KY Medicaid denial. Virginia - Anthem HealthKeepers Plus plan offered by HealthKeepers, Inc. Currently, Steven oversees DentaQuest teams that manage client partnerships to deliver dental benefits for millions of people across several states. 907 KAR 1:026 to provide covered services. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2023. DentaQuest knows that it can make a big change in the quality of life and a persons overall health and wellbeing, especially for a person with a disability. Optimizing and continuously improving these digital gateways is critical to ensuring a stellar customer experience. If your state isnt listed, visit www.bcbs.com for other coverage options. Program Summaryincludes a complete list of provider types we credential and those we do not. DentaQuests Health Equity Heroes program has recognized 67 heroes across 23 states and contributed more than $225,000 to local community organizations. A newsletter with tips and information to improve your oral health. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Award continues DentaQuests long-standing partnership with Florida to improve oral health outcomes statewide Tools. CRM Production Support Manager Jesus Jimenez oversees the team responsible for creating and maintaining member, client and provider web portals. Get help with mental health or substance abuse crises Make sure the ZIP code matches the area you want to search and choose Select this PCP.. All services must be medically necessary. 2021 copyright of Anthem Insurance Companies, Inc. As a leader in managed healthcare services for the public sector, Anthem Blue Cross and Blue Shield Medicaid helps low-income families, children and pregnant women get the healthcare they need. Take steps now to protect yourself and your family. Need help finding the right plan? This article discusses the complex barriers that keep people from accessing oral health care and how to think differently about how we deliver it. You can request the member handbook in paper format, which is available without charge upon request within 5 business days, by contacting Member Services at 1-855-690-7784 (TTY 711) Monday through Friday 7 a.m. to 7 p.m. How Much Can You Make To Apply For Medicaid, Difference Between Obamacare And Medicaid, Prior authorization updates for specialty pharmacy effective December 1, 2021, Prior authorization updates for specialty pharmacy effective January 1, 2022, Updates to AIM Specialty Health musculoskeletal interventional pain management clinical appropriateness guideline, Medical drug benefit clinical criteria updates, Protocol for providers serving members with hearing aid coverage administered by Hearing Care Solutions, New York City Medicare Advantage announcement, Medical policies and clinical utilization management guidelines update, Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines. . We credential licensed healthcare professionals with whom the company intends to contract and market to our members. Thats why its so important to celebrate pioneers in the industry who are paving the way for the next generation of dentists dentists like Dr. Darlene Sorrell. Most dental insurance plans have waiting periods for some procedures. Contribution will directly support dental students in California as they gain care delivery experience in communities with limited oral health access. Dentistsmust meet the coverage provisions and requirementsof Wed be happy to answer any insurance questions you may have, and work out a plan to provide you with the best possible dentistry care. Anthem Blue Cross and Blue Shield Medicaid (Anthem) is committed to supporting you in providing quality care and services to the members in our network. If you can't find the information you need or have additional questions, please direct your inquiries to: Billing Questions - Gainwell Technologies- (800) 807-1232 A dental plan can save you money on dental care and help protect the health of you and your family. Members should consult their Evidence of Coverage document to understand how many benefits they will be able to choose as well as benefit availability and details as benefits may vary by plan. A licensed Medicare insurance agent can help you gather information about available plans in your area from Anthem and other carriers that include dental coverage and can produce a list of local dental providers who accept Anthem insurance. Medical Policies & Clinical UM Guidelines, Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). EyeQuest is an independent company providing vision benefit management services on behalf of Anthem Blue Cross and Blue Shield Medicaid. The request must include the reason for the request along with a hard copy claim. As part of its mission to improve the oral health of all, DentaQuest is expanding access to dental care in three Florida Panhandle counties, all designated as dental health professional shortage areas (HPSAs).
