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Medicaid Updates

Medicaid Dental Program Updates

Please bookmark and check this page for frequent updates on Colorado's Medicaid Dental Program.

October 2014

  • State Medicaid Program Newsletter (see page 6 for dental updates)
    Includes updates on Children's Benefit Rulemaking and the Orthodontic Benefits Collaborative
  • DentaQuest Provider Newsletter
    Includes important updates on a forthcoming fee increase, PAR criteria for periodontal scaling and root planing, PAR clarifications for anesthesia services and contact information for Colorado DentaQuest team members

August 2014

July 2014

April 2014

March 2014

February 2014

November 2013

September 2013

May 2013

Other Helpful Resources


Take 5: Making Colorado healthier through access to a dentist


It’s Time to Take 5—and to Be Recognized for Your Commitment to Dental Access

Click to Join Take 5More than 300,000 Colorado adults qualify for dental coverage through the state’s Medicaid program. Many of these adults—including parents, expectant moms and people with chronic and developmental health conditions—are looking to access much-needed preventive and restorative dental care.

Colorado’s dentists are ready to care for these patients. The CDA took a leadership role in increasing Medicaid coverage. Through the CDA’s Take 5 program, dentists can further their commitment to helping address the oral health needs of our state.

The CDA's Take 5 Bonus Program Moves into Full Gear

The CDA is pleased to report that the Take 5 enhanced payment program that rewards new and existing Medicaid providers has finally received federal approval and payments are scheduled to begin in September. The CDA worked with the state legislature to establish this program, which was designed to help encourage dentists to sign up to see Medicaid patients by providing some incentive payments to help offset some set up costs associated with enrollment, training staff, and learning billing systems.
As previously shared with CDA members, the state Medicaid program plans to reward dentists with an extra payment of $1,000 for seeing their first five new Medicaid patients. An additional $1,000 is awarded to dentists who see another 50 patients (a total of 55 new Medicaid patients). And another $1,000 is provided to dentists who see another 50 new Medicaid patients (a total of $3,000 for dentists serving 105 new Medicaid patients). Dental hygienists who bill Medicaid directly for services may also be eligible for tiered bonuses under this program.
Existing Medicaid providers who qualify under the program will begin receiving mailed payments from DentaQuest in September. Each new Medicaid patient who is seen twice by the dental office between Oct. 1, 2014, and Dec. 31, 2015, will qualify under the program. The state has expanded the timeline for qualifying patient visits to 15 months (as compared to the original 12 months), allowing more flexibility to dental offices under the program. Existing Medicaid providers qualify automatically for the payments; no additional action is needed from the provider. DentaQuest will make reports of qualifying patients available to allow dentists to check their status in this bonus payment program.

Sign Up as a Provider

If you have not already signed up as a Medicaid provider, there's still time to qualify for this Take 5 payment program. It is important that you complete your Medicaid enrollment immediately, as these incentive dollars are available only for a limited time. It's important that new providers allow adequate time for processing of credentialing applications and to see the patients necessary to qualify for the enhanced payments. We encourage you to submit your credentialing application by the end of August to allow a sufficient participation window.

To start the provider enrollment process, download and complete the credentialing application online. Please use the 10 Tips for Successful Enrollment (below) to help with the application process. Assistance is available to ensure a successful application submission.

10 Tips for Successful Enrollment
1.    Call DentaQuest’s recruiters at 855-873-1283 to discuss your participation in Medicaid.
2.    Fill out the application. There are two different applications you must complete.
3.    Call Medicaid’s credentialing team at 800-237-0757 for help filling out the application.
4.    Make a copy of your application to reference if you have questions or need to make changes.
5.    Complete and return both provider applications.
6.    Note the date when you submit your application and call 800-237-0757 after 14 days to check your status.
7.    Check the status of your application if you have not received an update after 45 days. Inactive applications might need to be resubmitted.
8.    Expect an acceptance letter from Medicaid once your application is approved (usually within 2 weeks for a complete application).
9.    Contact your regional DentaQuest representative listed on the reverse side of this card once you receive your acceptance letter.
10.    Contact Gail Reeder with Colorado Medicaid at 303-866-5187 for technical questions about enrollment or application status.

For additional questions about Medicaid and to learn more about Take 5, please call the CDA at 303-740-6900 or email This email address is being protected from spambots. You need JavaScript enabled to view it. .

Resources for Take 5 Providers
DentaQuest Provider Relations Team:
Call 855-225-1731 for Provider Relations/Services.

For in-depth questions, contact DentaQuest Colorado’s regional representatives:
South Metro and Southeastern Colorado
Richard Spencer: 720-573-6996
Denver, West and North Metro and Northeastern Colorado
Lisa Larkin: 720-645-2998
Western Slope up to the Front Range
Christie Robson: 970-464-2240
Laura Jacob: 303-794-3226

More DentaQuest resources:
Visit and click “Dentist Page.”
Claims appeal information can be found in Section 2.04 of the office reference manual on DentaQuest’s webpage for Colorado dentists.
Refer patients with questions to 855-225-1729.

Medicaid resources:
For helpful provider resources, visit
Call 800-237-0757 with questions about provider enrollment.
Call Gail Reeder with Colorado Medicaid at 303-866-5187 with technical questions.

Medicaid Provider Resources


Dentists at the Capitol Sign Up and Calendar

Dentists at the Capitol Sign Up
Sign up to spend 3 hours at the state capitol to speak to legislators about the important issue of insurers dicating fees for services they don't cover. The CDA will provide all the training you need – including an orientation, review of key talking points, introductions to legislators and guidance during the discussion of the issue. Sign up today for a time in the next 3 weeks. Available times are listed in the calendar at the bottom of this page.

Tuesday, February 22, 2011 - to - Friday, March 25, 2011

Colorado State Capitol
Basement Level/Cafeteria Area
200 East Colfax Avenue
Denver, CO 80203
Driving Directions

Parking Instructions: There is a parking lot directly east of the state Capitol (between Colfax and 14th, Grant and Logan). Otherwise, you can look for street parking, other flat fee lots or meters in the area.

Jennifer Goodrum
Colorado Dental Association
This email address is being protected from spambots. You need JavaScript enabled to view it.


Sample Dentist LTEs

Sample Letters to the Editor from Dentists:

Use the letters below as templates to help you craft a letter to the editor of your local newspaper. Click here to find the email address of your local newspaper.


Dear editor,

Just about any problem left untreated will cost a lot more to resolve as time goes by. That's exactly what we see happening across Colorado among the thousands of emergency room patients each year who seek costly, acute care for abscesses and other oral health problems that could have been treated much earlier and more cost-effectively by dentists.

Too often, those seeking help so late are low-income Coloradans who couldn't afford to see a dentist for preventative care and early intervention. That's why Gov. John Hickenlooper's budget proposal to offer a dental coverage benefit to adults on Medicaid could be a real game changer. It not only will provide needed care for an underserved part of our state's population, but it will also benefit the rest of Colorado's health care consumers—who ultimately pick up the cost of preventable emergency room visits. By some estimates, $2 million to $5 million could be saved every year by helping low-income Coloradans visit a dentist before they need emergency care.

I'm one of the many dentists in our state who wants to help. A Medicaid dental benefit will enable us to make a difference. For a modest investment in the oral health of low-income adults, we'll be able to prevent far costlier care in the future. Greater access to dental care assures better overall health among the public in general.

[Dentist's name]

To the editor:

As a dentist who has served our community for years, I'd like to express my support for Senate Bill 242, pending legislation at the State Capitol that would offer a dental benefit to adults eligible for the state Medicaid program. Championed by Gov. John Hickenlooper, this important step in boosting our state's oral health can't come too soon.

Neglected dental care is a significant factor in driving up health care costs across Colorado. Too often, cavities and other routine oral health problems that could be treated effectively and inexpensively through the timely intervention of a dentist are put off—often due to financial limitations. As these problems progress, they often turn into an expensive trip to the local emergency room. In fact, there were up to 39,000 unnecessary emergency room visits last year in our state for dental emergencies. And the costs for those visits inevitably are passed to other consumers through higher health insurance premiums.

By some estimates, $2 million to $5 million could be saved each year by preventing such trips to the emergency room through earlier intervention, which is to say an ounce of prevention truly is worth a pound of cure. That's why the governor's proposal for an adult Medicaid dental benefit makes so much sense. Investing in dental care now for some of our underserved citizens will improve their overall and oral health—and will help avoid costly emergency room visits down the road.

[Dentist's name]


Key Issues

Key Issues

{access public}Please log in using the login box at the top right corner of your screen to view content.{/access}{access !public}The alerts listed below address key issues for the dental profession at the local, state and federal levels. Please take 5 minutes now and send a message to your legislator on these issues. Be sure to customize your letter to make it more effective!



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