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Elizabeth M. Whitehorn, Director

Provider Notice Issued 09/20/2018

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DATE:   September 20, 2018      

 

TO:       Federally Qualified Health Centers (FQHCs)

 

RE:       Dental Encounters

 

 

This notice informs enrolled Federally Qualified Health Centers (FQHCs) that effective with services provided on and after August 19, 2018, a billable dental encounter includes services performed by dental hygienists under the general supervision of a dentist

 

Healthcare and Family Services (Department) will reimburse in accordance with the FQHC’s encounter rate for covered services provided to medical assistance participants by a dental hygienist, as defined under the Illinois Dental Practice Act, working under the general supervision of a dentist and employed by an FQHC.

 

Only one dental encounter per patient per day is eligible for reimbursement. Dental encounter claims must be submitted to the Department’s dental contractor, DentaQuest. For billing information, refer to the Dental Office Reference Manual (DORM).

 

This notice applies to fee-for-service reimbursements. For clients enrolled in one of HealthChoice Managed Care plans providers should contact that Plan for reimbursement and billing information.

 

Questions regarding this notice should be directed to a provider representative or the Department’s Bureau of Professional and Ancillary Services at 877-782-5565.

 

 

 

Teresa T. Hursey

Medicaid Director