SOONERSELECT DENTAL

SOONERSELECT
DENTAL
Getting Started and Preparedness for Day One
January 2024
DISCLAIMER
SoonerCare policy is subject to change.
The information included in this presentation is current
as of January 2024.
Current information can be found on the OHCA public
website: 
www.Oklahoma.gov/ohca
.
CLASS DESCRIPTION
This class 
will provide you with the tools you need to be
successful during the transition and implementation of the
SoonerSelect dental program
.
Recommended audience: All SoonerCare dental providers
and staff.
AGENDA
What providers need to know:
Provider checklist
Contracting information
Contact information
Tribal Provider information
Verification of member eligibility and dental plan
Prior authorizations
Claims
Continuity of care
Assistance for members with transition to SoonerSelect
Resources
Questions
PROVIDER
CHECKLIST
PROVIDER CHECKLIST
To continue serving all SoonerCare members who transition to SoonerSelect,
providers 
should complete the following as soon as possible prior to go-live:
Review & execute contracts with either or both SoonerSelect dental plans, which
are DentaQuest and LIBERTY Dental.
Review 
DentaQuest
’s and 
LIBERTY Dental’s
 
b
enefits and 
extra benefits
.
Review your provider information with each SoonerSelect dental plan for
accuracy. Submit changes to the dental plan if information is incorrect or
inaccurate.
Review “Day 1: SoonerSelect Dental Program Provider Quick Reference
Guide”
 
 for information to know on the first day of SoonerSelect dental program
launch.
Encourage their patients enrolled in SoonerSelect dental to select a Primary
Care Dentist (PCD) by contacting their dental plan.
CONTRACTING
INFORMATION
CONTRACTING INFORMATION
OHCA encourages all dental providers to contract with both
DentaQuest and LIBERTY Dental to continue serving all
SoonerCare members who transition to SoonerSelect.
Contact the dental plans for more information on provider
contracting.
DentaQuest
 Provider Network Development:
 855-873-1283
DentaQuest.com
 
NetworkDevelopment@DentaQuest.com
LIBERTY Dental Provider Network Development:
 888-902-0342
LibertyDentalPlan.com
 
okprinquiries@libertydentalplan.com
CONTACT
INFORMATION
CONTACT INFORMATION
It is important that all provider contact information is accurate for
SoonerSelect dental members. Providers should confirm that their
contact information, practice and affiliation is correctly listed with
DentaQuest and LIBERTY Dental prior to February 1, 2024.
Incorrect or missing information may impact a member’s ability to
choose you as their PCD or find you for services. 
Please review your
information directly with 
each dental plan.
DentaQuest:
 833-479-1007 | 
DentaQuest.com
 
| 
DentaQuest Provider Portal
LIBERTY Dental:
 888-902-0342 | 
LibertyDentalPlan.com
 
| 
LIBERTY Dental
Plan Provider Portal
TRIBAL
PROVIDER
INFORMATION
TRIBAL PROVIDER INFORMATION
OHCA will reimburse claims for services provided by
Indian Health Care Providers (IHCPs). IHCPs should submit
all claims directly to OHCA for reimbursement for
SoonerSelect dental members.
For more information, please contact the OHCA Tribal
Government Relations team at:
TribalGovernmentRelations@okhca.org
.
VERIFICATION
OF MEMBER
ELIGIBILITY
AND DENTAL
PLAN
VERIFICATION
OHCA offers two methods of confirming member eligibility and dental
plan – the online provider portal and the OHCA Provider Helpline.
On the provider portal, providers will be able to identify that a member is
enrolled in SoonerSelect dental by looking under the Coverage Section.
SoonerDental indicates SoonerSelect dental.
Temporarily, the SoonerSelect dental plan assignments for members will
not be visible online. OHCA is diligently working to update our secure
provider portal eligibility screen so that providers may verify member
eligibility information electronically. OHCA will notify providers when this
information is available via global message. Providers can also call the
OHCA Provider Helpline
 at 800-522-0114, option 1 to verify member
eligibility and dental plan assignment.
ID CARDS
Providers may ask the member for their dental plan ID
card, which will display the dental plan in which the
member is enrolled. Examples of SoonerSelect dental
member ID cards are below. If the member does not have
their ID card, members can log onto the
MySoonerCare.org
 
member portal to see their dental plan
assignment.
DENTAQUEST EXAMPLE
MEMBER ID CARD
LIBERTY DENTAL EXAMPLE
MEMBER ID CARD
PRIOR
AUTHORIZATIONS
PRIOR AUTHORIZATIONS
Members will have a 90-day period to ensure continuity of
care where any services with a prior authorization (PA) under
SoonerCare will be honored. DentaQuest and LIBERTY Dental
Plan will process PAs through their internal processes and
secure provider portals.  Please directly contact the dental
plans for training needs or questions on PAs.
DentaQuest:
 833-479-1007 | 
DentaQuest.com
 
| 
DentaQuest
Provider Portal
LIBERTY Dental:
 888-902-0342 | 
LibertyDentalPlan.com
 
|
LIBERTY Dental Plan Provider Portal
CLAIMS
CLAIMS
DentaQuest and LIBERTY Dental will process claims
through their internal processes and secure provider
portals. Please directly contact the dental plans for
training needs or questions on claims.
DentaQuest:
 833-479-1007 | 
DentaQuest.com
 
|
DentaQuest Provider Portal
LIBERTY Dental:
 888=902-0342 | 
LibertyDentalPlan.com
 
|
LIBERTY Dental Plan Provider Portal
CONTINUITY
OF CARE
CONTINUITY OF CARE
If a patient is a SoonerSelect Dental member and the provider is not
currently contracted with the member’s SoonerSelect dental plan,
the provider must:
Notify the member that they can only provide services for up to 90
calendar days.
Follow the dental plan’s guidelines and procedures for out-of-
network care during the 90-day period.
Note that payments to dental providers that have not yet
contracted with dental plans will be made at the current Medicaid
fee schedule rate.
For questions specific to each SoonerSelect Dental plan, please
contact the plan directly. For general SoonerSelect provider
questions, providers may contact the OHCA Provider Helpline at
800-522-0114.
ASSISTANCE
FOR MEMBERS
WITH
TRANSITION TO
SOONERSELECT
ASSISTANCE FOR MEMBERS
All members had an opportunity to pick a SoonerSelect dental
plan. Members who did not make an active selection were
assigned a dental plan.
Members have 90 calendar days (until May 1, 2024) if they wish to
change dental plans. 
Providers cannot select or change a
SoonerSelect dental plan on behalf of a member.
Members should log on to 
MySoonerCare.org 
to change their
dental plan or contact the 
OHCA Member Choice Counseling
Hotline 
at 800-987-7767, Option 5.
Members will have a 90-day period to ensure continuity of care
where any services with a prior authorization (PA) under
SoonerCare will be honored.
ASSISTANCE FOR MEMBERS
Members may ask providers questions about
SoonerSelect 
d
ental. Members can contact their dental
plan directly with any questions about their services, their
PCD, in-network providers, PAs, or care management.
DentaQuest:
 833-479-0687| 
DentaQuest.com
 
LIBERTY Dental Plan:
 888-700-1093 |
LibertyDentalPlan.com
 
 
RESOURCES
RESOURCES
DentaQuest Provider Phone Number: 833-479-1007
DentaQuest Provider Email:
NetworkDevelopment@DentaQuest.com
 
LIBERTY Dental Provider Phone Number: 888-902-3042
LIBERTY Dental Provider Email
:
okprinquiries@libertydentalplan.com
OHCA Provider Helpline
: 
800-522-0114
OHCA Website:
 
SoonerSelect Dental Plans
OHCA Member
 
Helpline
: 
800-987-7767
QUESTIONS?
GET IN TOUCH
Slide Note
Embed
Share

This guide provides essential information for dental providers transitioning to the SoonerSelect dental program in January 2024. It covers key topics such as provider checklist, contracting details, tribal provider information, member eligibility verification, claims process, continuity of care, and resources available. Ensure a smooth transition by reviewing this comprehensive guide.

  • Dental Providers
  • SoonerSelect Program
  • Provider Checklist
  • Contracting Information
  • Dental Care

Uploaded on Apr 20, 2024 | 5 Views


Download Presentation

Please find below an Image/Link to download the presentation.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.

You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.

The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.

E N D

Presentation Transcript


  1. SOONERSELECT DENTAL Getting Started and Preparedness for Day One January 2024

  2. DISCLAIMER SoonerCare policy is subject to change. The information included in this presentation is current as of January 2024. Current information can be found on the OHCA public website: www.Oklahoma.gov/ohca. 2 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  3. CLASS DESCRIPTION This class will provide you with the tools you need to be successful during the transition and implementation of the SoonerSelect dental program. Recommended audience: All SoonerCare dental providers and staff. 3 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  4. AGENDA What providers need to know: Provider checklist Contracting information Contact information Tribal Provider information Verification of member eligibility and dental plan Prior authorizations Claims Continuity of care Assistance for members with transition to SoonerSelect Resources Questions 4 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  5. PROVIDER CHECKLIST

  6. PROVIDER CHECKLIST To continue serving all SoonerCare members who transition to SoonerSelect, providers should complete the following as soon as possible prior to go-live: Review & execute contracts with either or both SoonerSelect dental plans, which are DentaQuest and LIBERTY Dental. Review DentaQuest s and LIBERTY Dental s benefits and extra benefits. Review your provider information with each SoonerSelect dental plan for accuracy. Submit changes to the dental plan if information is incorrect or inaccurate. Review Day 1: SoonerSelect Dental Program Provider Quick Reference Guide for information to know on the first day of SoonerSelect dental program launch. Encourage their patients enrolled in SoonerSelect dental to select a Primary Care Dentist (PCD) by contacting their dental plan. 6 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  7. CONTRACTING INFORMATION

  8. CONTRACTING INFORMATION OHCA encourages all dental providers to contract with both DentaQuest and LIBERTY Dental to continue serving all SoonerCare members who transition to SoonerSelect. Contact the dental plans for more information on provider contracting. DentaQuest DentaQuest Provider Network Development: Provider Network Development: 855-873-1283 | DentaQuest.com | NetworkDevelopment@DentaQuest.com LIBERTY Dental Provider Network Development: LIBERTY Dental Provider Network Development: 888-902-0342 | LibertyDentalPlan.com | okprinquiries@libertydentalplan.com 8 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  9. CONTACT INFORMATION

  10. CONTACT INFORMATION It is important that all provider contact information is accurate for SoonerSelect dental members. Providers should confirm that their contact information, practice and affiliation is correctly listed with DentaQuest and LIBERTY Dental prior to February 1, 2024. Incorrect or missing information may impact a member s ability to Incorrect or missing information may impact a member s ability to choose you as their PCD or find you for services. choose you as their PCD or find you for services. Please review your information directly with each dental plan. DentaQuest: DentaQuest: 833-479-1007 | DentaQuest.com | DentaQuest Provider Portal LIBERTY Dental: LIBERTY Dental: 888-902-0342 | LibertyDentalPlan.com | LIBERTY Dental Plan Provider Portal 10 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  11. TRIBAL PROVIDER INFORMATION

  12. TRIBAL PROVIDER INFORMATION OHCA will reimburse claims for services provided by Indian Health Care Providers (IHCPs). IHCPs should submit all claims directly to OHCA for reimbursement for SoonerSelect dental members. For more information, please contact the OHCA Tribal Government Relations team at: TribalGovernmentRelations@okhca.org. 12 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  13. VERIFICATION OF MEMBER ELIGIBILITY AND DENTAL PLAN

  14. VERIFICATION OHCA offers two methods of confirming member eligibility and dental plan the online provider portal and the OHCA Provider Helpline. On the provider portal, providers will be able to identify that a member is enrolled in SoonerSelect dental by looking under the Coverage Section. SoonerDental indicates SoonerSelect dental. Temporarily, the SoonerSelect dental plan assignments for members will not be visible online. OHCA is diligently working to update our secure provider portal eligibility screen so that providers may verify member eligibility information electronically. OHCA will notify providers when this information is available via global message. Providers can also call the OHCA Provider Helpline OHCA Provider Helpline at 800-522-0114, option 1 to verify member eligibility and dental plan assignment. 14 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  15. 15 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  16. ID CARDS Providers may ask the member for their dental plan ID card, which will display the dental plan in which the member is enrolled. Examples of SoonerSelect dental member ID cards are below. If the member does not have their ID card, members can log onto the MySoonerCare.org member portal to see their dental plan assignment. 16 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  17. DENTAQUEST EXAMPLE MEMBER ID CARD 17 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  18. LIBERTY DENTAL EXAMPLE MEMBER ID CARD 18 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  19. PRIOR AUTHORIZATIONS

  20. PRIOR AUTHORIZATIONS Members will have a 90-day period to ensure continuity of care where any services with a prior authorization (PA) under SoonerCare will be honored. DentaQuest and LIBERTY Dental Plan will process PAs through their internal processes and secure provider portals. Please directly contact the dental plans for training needs or questions on PAs. DentaQuest: DentaQuest: 833-479-1007 | DentaQuest.com | DentaQuest Provider Portal LIBERTY Dental: LIBERTY Dental: 888-902-0342 | LibertyDentalPlan.com | LIBERTY Dental Plan Provider Portal 2 0 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  21. CLAIMS

  22. CLAIMS DentaQuest and LIBERTY Dental will process claims through their internal processes and secure provider portals. Please directly contact the dental plans for training needs or questions on claims. DentaQuest: DentaQuest: 833-479-1007 | DentaQuest.com | DentaQuest Provider Portal LIBERTY Dental: LIBERTY Dental: 888=902-0342 | LibertyDentalPlan.com | LIBERTY Dental Plan Provider Portal 2 2 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  23. CONTINUITY OF CARE

  24. CONTINUITY OF CARE If a patient is a SoonerSelect Dental member and the provider is not currently contracted with the member s SoonerSelect dental plan, the provider must: Notify the member that they can only provide services for up to 90 calendar days. Follow the dental plan s guidelines and procedures for out-of- network care during the 90-day period. Note that payments to dental providers that have not yet contracted with dental plans will be made at the current Medicaid fee schedule rate. For questions specific to each SoonerSelect Dental plan, please contact the plan directly. For general SoonerSelect provider questions, providers may contact the OHCA Provider Helpline at 800-522-0114. 2 4 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  25. ASSISTANCE FOR MEMBERS WITH TRANSITION TO SOONERSELECT

  26. ASSISTANCE FOR MEMBERS All members had an opportunity to pick a SoonerSelect dental plan. Members who did not make an active selection were assigned a dental plan. Members have 90 calendar days (until May 1, 2024) if they wish to change dental plans. Providers cannot select or change a Providers cannot select or change a SoonerSelect dental plan on behalf of a member. SoonerSelect dental plan on behalf of a member. Members should log on to MySoonerCare.org to change their dental plan or contact the OHCA Member Choice Counseling OHCA Member Choice Counseling Hotline Hotline at 800-987-7767, Option 5. Members will have a 90-day period to ensure continuity of care where any services with a prior authorization (PA) under SoonerCare will be honored. 2 6 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  27. ASSISTANCE FOR MEMBERS Members may ask providers questions about SoonerSelect dental. Members can contact their dental plan directly with any questions about their services, their PCD, in-network providers, PAs, or care management. DentaQuest: DentaQuest: 833-479-0687| DentaQuest.com LIBERTY Dental Plan: LIBERTY Dental Plan: 888-700-1093 | LibertyDentalPlan.com 2 7 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  28. RESOURCES

  29. RESOURCES DentaQuest Provider Phone Number: 833 DentaQuest Provider Phone Number: 833- -479 DentaQuest Provider Email: DentaQuest Provider Email: NetworkDevelopment@DentaQuest.com LIBERTY Dental Provider Phone Number: 888-902-3042 LIBERTY Dental Provider Email LIBERTY Dental Provider Email: okprinquiries@libertydentalplan.com OHCA Provider Helpline OHCA Provider Helpline: 800 800- -522 OHCA Website: OHCA Website: SoonerSelect Dental Plans OHCA Member OHCA Member Helpline Helpline: 800 800- -987 479- -1007 1007 522- -0114 0114 987- -7767 7767 2 9 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

  30. QUESTIONS?

  31. G E T I N T O U C H 4345 N. Lincoln Blvd. Oklahoma City, OK 73105 oklahoma.gov/ohca MySoonerCare.org Agency: 405-522-7300 Helpline: 800-987-7767 31 | OK L A H OM A H EA L TH C A RE A U TH ORI TY

Related


More Related Content

giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#giItT1WQy@!-/#