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TN Tenncare Office Reference Manual

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TN Tenncare Office Reference Manual TENNCARESM EPSDT OFFICE REFERENCE MANUAL Managed by DentaQuest USA Insurance CO., LLC. PO Box 2906 Milwaukee, WI 53201-2906 855-418-1623 The Office Reference Manual is subject to periodic updates; please ensure that you are using the latest version. The most current copy can be found online at www.dentaquest.com. Go to the Tennessee link and go to the provider resources tab to view. Each quarter you can find what sections received updates or changes in your provider newsletter. 1 DentaQuest LLC August 2, 2021 Current Dental Terminology © American Dental Association. All Rights Reserved. Introduction Addresses and Telephone Numbers DentaQuest Customer Service Authorizations should be sent to: Member Services: 855.418.1622 DentaQuest – TennCare Authorizations Provider Services: 855.418.1623 PO Box 2906 PO Box 2906 Milwaukee, WI 53201-2906 Milwaukee, WI 53201-2906 Fax: 262.241.7150 or 888.313.2883 Fax numbers: Claims to be reprocessed: 262.834.3589 Outpatient/Hospital Fax: 262.834.3575 Claims Questions: [email protected] Dental claims should be sent to: DentaQuest – TennCare Claims Eligibility or Benefit Questions: PO Box 2906 [email protected] Milwaukee, WI 53201-2906 TDD/TTY (Hearing Impaired): Electronic Claims should be sent: Direct entry on the web www.dentaquest.com 800.466.7566 Or, Via Clearinghouse – Payer ID CX014 Include address on electronic claims: Special Needs Member Services: DentaQuest, LLC PO Box 2906 800.660.3397 Milwaukee, WI 53201-2906 TennCare Fraud Hotline: Provider Appeals 800.433.3982 DentaQuest – TennCare Appeals PO Box 2906 Web Site: Milwaukee, WI 53201-2906 Fax: 262.834.3452 www.dentaquest.com Or Via Provider Web Portal State of Tennessee TennCareSM Member Medical Appeals Division of TennCareSM P.O. Box 000593 310 Great Circle Road Nashville, TN 37202-0593 Nashville, TN 37243 800.878.3192 http://www.tn.gov/tenncare/ TennCare Connect 855.259.0701 Credentialing PO Box 2906 Milwaukee, WI 53201-2906 Credentialing Hotline: 800.233.1468 Fax: 262.241.4077 2 DentaQuest LLC August 2, 2021 Current Dental Terminology © American Dental Association. All Rights Reserved. Tagline & Notice Templates Do you need free help with this letter? If you speak a language other than English, help in your language is available for free. This page tells you how to get help in a language other than English. It also tells you about other help that’s available. Spanish: Español ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-418-1622 (TRS:711). ﮐوردی :Kurdish ﺋﺎﮔﺎداری :ﺋﮫﮔﮫر ﮫﺑ زﻣﺎﻧﯽ ﮐوردی ﮫﺳﮫﻗ دەﮐﮫﯾت، ﺧزﻣﮫﺗﮕوزارﯾﮫﮐﺎﻧﯽ ﯾﺎرﻣﮫﺗﯽ زﻣﺎن، ﺑﮫﺧۆڕاﯾﯽ، ﺑۆ ﺗۆ 1-855-418-1622 ..(TRS:711)ﺑﮫردەﺳﺗﮫ .ﭘﮫﯾوەﻧدی ﮫﺑ ﮫﮑﺑ رﺑﯾﺔﻌﻟا :Arabic وظﺔﺣﻟﻣ: اذا مﻟﻛﺗﺗ ةﻐﻟﻟا رﺑﯾﺔﻌﻟا اتﻣدﺧ دةﻋاﺳﻣﻟا وﯾﺔﻐﻟﻟا رةﻓوﺗﻣ كﻟ اﻧﺟﺎﻣ. اﺗﺻل مﻗﺑرTRS: -855-1) (و مﻛﺑﻟا711 مﻗر فﺗاھ ﺻمﻟا :418-1622 Chinese: 繁體中文 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-855-418-1622 (TRS:711). Vietnamese: Tiếng Việt CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-418-1622 (TRS:711). Korean: 한국어 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-855-418-1622 (TRS:711).번으로 전화해 주십시오. French: Français ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-855-418-1622 (TRS:711). Amharic: አማርኛ ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከነ የትርጉም እርዳታ ድርጅቶች፣በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-8855-418-1622 (መስማት ለተሳናቸው:TRS:711 ). Gujarati: �જરાતી �ચુ નુા: જુ તમુ �જરુાતુી બુ લતુા હુ , તુ િુન:�લ્ ુ ક ભુાષુા સહુાય સુ વુાઓ તમારુા મુાટ� ઉપલબુ્ ધ છુ . ફુ ન કર 1-855-418-1622 (TRS:711) . Laotian: ພາສາລາວ ໂປດຊາບ: ຖ້ າວ້ າ ທ້ ານເວ ້ ້ າພາສາ ລາວ, ການບ້ ລ້ ການຊ້ ວຍເຫ້ ້ ອດ້ ານພາສາ, ໂດຍບ້ ້ ເສ້ ຽຄ້ າ, ແມ້ ນມ້ ພ້ ອມໃຫ້ ທ ານ. ໂທຣ 1-855-418-1622 (TRS:711). German: Deutsch ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-855-418-1622 (TRS:711). Tagalog: Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-855-418-1622 (TRS:711). 3 DentaQuest LLC August 2, 2021 Current Dental Terminology © American Dental Association. All Rights Reserved. Hindi: �हુ द� धુ यુ न द�: य�द आप �हુ द� बુ लतુ ह� तુ आपकુ �लए मफુ त म� भ षુ सहુ यतુ स वુ एુ उपलबુ ध ह�।1- 855-418-1622 (TRS:711) . पर कુ ल कर�। 4 DentaQuest LLC August 2, 2021 Current Dental Terminology © American Dental Association. All Rights Reserved. Serbo-Croatian: Srpsko-hrvatski OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 1-855-418-1622 (TRS- Telefon za osobe sa oštećenim govorom ili sluhom: 711). Russian: Русский ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-855-418-1622 (телетайп: TRS:711 ). Nepali: न प ल� धુ यુ न �दनहુ ુ स:ુ तप इ�लુ नુ पુ ल� बુ ल नુह ુ न छ भनુ तपુ इ�कુ �निુम त भ षુ सहુ यतુ स वુ ह셂 �नુ श ુल क रુ पमુ उपलबુ ध छ । फુ न गनरુ ુह ુ स ુ 1-855-418-1622 (�ट�टवુ इ: TRS:711 । ﻓﺎرﺳﯽ :Persian ﺑﺎ ﺗﻣﺎس . اﮔر ﺑﮫ زﺑﺎن ﻓﺎرﺳﯽ ﮔﻔﺗﮕو ﻣﯽ ﮐﻧﯾد، ﺗﺳﮭﯾﻼت زﺑﺎﻧﯽ ﺑﺻورت راﯾﮕﺎن ﺑرای ﺷﻣﺎ ﻓراھﻢ ﻣﯽ ﺑﺎﺷد:ﺗوﺟﮫ TRS:711). 1-855-418-1622)ﺑﮕﯾرﯾد • Do you need help talking with us or reading what we send you? • Do you have a disability and need help getting care or taking part in one of our programs or services? • Or do you have more questions about your health care? Call us for free at 855-418-1622 We can connect you with the free help or service you need. (For TRS call: 711) We obey federal and state civil rights laws. We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion, or sex. Do you think we did not help you or you were treated differently because of your race, color, birth place, language, age, disability, religion, or sex? You can file a complaint by mail, by email, or by phone. Here are three places where you can file a complaint: TennCare MCO U.S. Department of Health & Human Office of Civil Information Services Rights DentaQuest Office for Civil Rights Compliance 310 PO Box 2906 200 Independence Ave SW, Rm 509F, HHH Great Circle Road, Milwaukee, WI 53201-2906 Bldg 3W Nashville, 855-418-1622 Washington, DC 20201 Tennessee 37243 Phone: 800-368-1019 Email: (TDD): 800-537-7697 HCFA.Fairtreatment @tn.gov Phone: 855-857-1673 (TRS 711) You can get a You can get a complaint form online at: complaint form online http://www.hhs.gov/ocr/office/file/index.html at: Or you can file a complaint online at: https://www.tn.gov/co https://ocrportal.hhs.gov/ocr/portal/lobby.jsf ntent/dam/tn/tenncare /documents/complaint form.pdf 5 DentaQuest LLC August 2, 2021 Current Dental Terminology © American Dental Association. All Rights Reserved. Program Objective The primary objective of TennCare’s Medicaid Dental program is to create a comprehensive dental care system offering quality dental Covered Services that are Medically Necessary to eligible Tennessee residents. We emphasize early intervention and promote access to necessary dental care, thereby improving health outcomes for Tennessee residents. Are you building a “Dental Home” for your members? Effective October 1, 2013, DentaQuest USA Insurance Company, Inc. (DentaQuest) will be implementing the Dental Home program in Tennessee for Medicaid Members. The Main Dental Home is a place where a child’s oral health care is delivered in a complete, accessible and family-centered manner by a licensed dentist. This concept has been successfully employed by primary care physicians in developing a “Medical Home” for their Members, and the “Dental Home” concept mirrors the “Medical Home” for primary dental and oral health care. If expanded or specialty dental services are required, the general dentist is not expected to deliver the services, but to coordinate the referral and to monitor the outcome. Provider support is essential to effectively employ the Dental Home program for Medicaid Dental Program Members. With assistance and support from dental professionals, a system for improving the overall health of children in the Medicaid Program can be achieved. Dental Home Initiative Providers who are contracted with DentaQuest for the TennCare Program will automatically be included in the Dental Home Initiative. For additional information regarding the Dental Home program, please connect to the DentaQuest Provider Web Portal www.dentaquest.com under Related Documents – Dental Home. Assigning members to a Dental Home DentaQuest’s Dental Home auto-assignment function follows the below hierarchy when assigning members to a dental home: • If the member has history with a provider office, the member is assigned to the provider office with which they have history in order to support the continuation of an existing provider/member relationship. • If the member does not have history with a provider office, but they have a family member that is assigned to a provider office, the member is assigned to the same provider office that their family member is linked to. This ensures family members are kept together. • If the member does not have history or a family member assigned to a dental home, the member is assigned to the closest higher-performing provider office that is accepting new members and has open capacity. 6 DentaQuest LLC August 2, 2021 Current Dental Terminology © American Dental Association.
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