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Elizabeth M. Whitehorn, Director

Provider Notice issued 07/07/14

Dental Office Reference Manual (DORM)

To:​ ​All Enrolled Medical Assistance Providers
​Date: ​July 7, 2014
Re: Dental Office Reference Manual (DORM)​

This informational notice is to notify you of the changes in the DORM. Following is an outline of the changes:

  • Manage Care Organizations (MCOs) will now be responsible for reimbursing dental services provided to a patient who is enrolled in a MCO.

  • The adult benefit table and fee schedule in the DORM have been updated to reflect the restoration of adult dental services.

  • Benefits Covered for Pregnant Women has been added to the DORM which describes the five preventive dental services that pregnant women are eligible for prior to the birth of their child.

  • As of August 1, 2014, the All Kids School-Based Dental Program will require the use of one of the following dental codes (D0601, D0602, or D0603) for school-based claims to be reimbursed. The D0601, D0602 or D0603 will be used as the new method of reporting oral health scores.

If you have questions regarding the changes to the DORM, please contact your DentaQuest provider representative:

Timika Nunley at 855-333-8997

Jennifer Straub at 855-451-8814 or

DentaQuest Provider Relations Hotline at 888-281-2076

DentaQuest will mail CDs of the DORM and it will also be posted to the DentaQuest provider Web portal and on the HFS Dental Web page.

Theresa A. Eagleson, Administrator

Division of Medical Programs