It’s Time to Take 5—and to Be Recognized for Your Commitment to Dental Access
More 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 firstname.lastname@example.org.
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 dentaquest.com/colorado 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.
For helpful provider resources, visit www.colorado.gov/hcpf/provider-services.
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
- DentaQuest: Provider Website
Includes news and updates, contacts, ORM, fee schedule, portal access and more
- Cavity Free at Three: Resources for Provider Enrollment (See “How to Enroll”)
Please note that these tutorials reference an older version of the Medicaid website, so some referenced tools on the Medicaid website may have moved
- State Medicaid Program: Provider Enrollment Guide
This guide provides general information for all healthcare providers. It provides a great overview of the enrollment process, but is not specific to the dental profession.
- State Medicaid Program: Dental Provider Enrollment Webinar, FAQs and Enrollment Tools (expand the “Dental Providers” section)
Specific guidance for the dental profession
- State Medicaid Program: Dental Provider Enrollment Forms
- State Medicaid Program: Dental Benefit Coverage Rules (see Section 8.201 for adults, Section 8.202 for children)