HCA: Orthodontic Temporary COVID Policy Recalled for Billing Quarterly Units Without Seeing Client

Dental Medicaid

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HCA: Orthodontic Temporary COVID Policy Recalled for Billing Quarterly Units Without Seeing Client

The Health Care Authority (HCA) recently sent the following alert to dental Medicaid providers.

Apple Health (Medicaid) Provider Alert

Attention Orthodontic providers:

The temporary COVID policy allowing the provider to bill a quarterly unit of orthodontic services without seeing the client is recalled. Effective immediately, all orthodontic providers must see the client at least once in a quarter to bill for orthodontic services.

It is the expectation of the Health Care Authority that, even though a provider was able to bill a quarterly unit of services without seeing the client due to office shut downs, the provider will still complete the client’s services in the original units allotted.

Medicaid Transition to Managed Care Cancelled

The 2019 Legislature has directed the Washington State Health Care Authority (HCA) to continue to administer the dental Medicaid program through fee-for-service. The HCA may not proceed with a carved-out or carved-in managed care dental option at this time.

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