Webinar scheduled

Please plan to attend a webinar about the Upcoming Changes for AR Medicaid Dental Services – Friday, July 19, 2024, at 12:00PM. This webinar is intended for Dental providers. Click here for more.

Dental Fee-For-Service Provider Frequently Asked Questions (FAQs)

Question: What is happening with the Medicaid dental program in November?

Answer: Since 2018, the Arkansas Department of Human Services (DHS) has operated the Medicaid dental program by paying MCNA and Delta Dental a flat rate for each beneficiary eligible for dental services. MCNA and Delta Dental were then responsible for paying for the dental claims for their enrolled beneficiaries. Beginning November 1, the dental program will return to fee for service, meaning dental providers will bill Medicaid directly for the eligible dental services they provide. Clients will use their Medicaid ID to receive services, not their MCNA or Delta Dental cards.

Reimbursement Rates

Question:  Does Medicaid anticipate an increase in reimbursement rates?

Answer: Medicaid reimbursement rates are the same as paid under Delta Dental and MCNA. At this time, there will be no rate increase in reimbursement rates. Current reimbursement rates can be viewed here. Medicaid continuously evaluates rates for all programs.

Question: Will dental providers be able to participate in the Arkansas Diamond Deferred Compensation Plan?

Answer: Yes, Medicaid dental providers will be able to contribute a portion of their Medicaid income on a pre-tax basis, or post-tax ROTH basis, to the State of Arkansas Diamond Deferred Compensation 457(b) Plan as an element of their retirement planning. Plan information and enrollment packets are available on request via email or regular mail. Contact your Arkansas Diamond Plan representative (Cheryl Daughenbaugh or Brete Garland) with Stephens Inc. at myardiamondplan@stephens.com or 501-301-9900. You can also contact Robert Jones at 501-377-8112 or rjones@stephens.com to request an information packet or further inquiry.

Covered Services

Question:  What services are covered under Medicaid fee for service?

Answer: Medicaid’s fee for service program covers most of the services Delta Dental and MCNA cover, but some services are not covered.Current covered services can be viewed here. At this time, there will be no changes in the Medicaid covered services, but Medicaid continuously evaluates covered services for all programs.

Prior Authorizations

Question:  What services require a prior authorization (PA) under fee for service, and how will providers submit PAs?

Answer: Medicaid covered services and those that require a PA are listed here.Dental providers should continue to submit PAs to MCNA or Delta Dental for services they intend to provide before Nov. 1. Beginning October 18, dental providers should submit all PAs to Medicaid.More information and training on how providers will submit PAs to Medicaid will be provided in the coming months.

Question: How can I become a reviewer for Medicaid PAs?

Answer: DHS is in the process of working through this topic. More information will be shared when it is available.

Question: How will orthodontic treatment already under way be paid for?

Answer: If banding has occurred (if the appliances have been installed) on or before November 1, 2024, Delta Dental and MCNA will pay out the remaining sum. If banding has not occurred (if the appliances have not been installed), FFS will pay an upfront sum for the services.

Question: Will the payouts for approved orthodontic treatment be paid up front when treatment starts, or will the payments be made in installments?

Answer: Medicaid pays for orthodontic treatment as an upfront sum for clients who are in Medicaid fee for service when the orthodontic treatment begins.

Question:  Will patients who have already received orthodontic treatment under Managed Care be eligible for additional orthodontic services?

Answer: No. Medicaid fee-for-service policies do not allow for more than one orthodontic treatment to be reimbursed per a beneficiary’s lifetime. Treatment received under managed care will count toward a beneficiary’s lifetime limits.

Question: How will dentures already under way be paid for?

Answer: Delta Dental and MCNA will pay all claims for dentures with a seat date (the date the dentures are delivered to the patient) before Nov. 1. Medicaid will pay claims for dentures initiated before Nov. 1 with a seat date on or after Nov. 1, 2024.

Question: Can I continue to use the lab of my choice for things like dentures and crowns?

Answer: Dental providers can select the labs they wish to use for all services, EXCEPT for the creation of dentures. Medicaid contracts with Green Dental to create all dentures for beneficiaries enrolled in the dental fee for service program.

Question: How will other multi-visit treatments (e.g., crowns) already under way be paid for?

Answer: Delta Dental and MCNA will pay all claims for multi-visit treatments with a seat date (the date the crowns or other prosthetic appliances are delivered to the patient) before Nov. 1. Medicaid will pay claims for all other multi-visit treatment initiated before Nov. 1 with a seat date on or after Nov. 1, 2024.

Question: How will Dental providers be supported during this transition? 

Answer: DHS will providejob aids and instructional videos to help with Medicaid billing and prior authorization processing. DHS will also provide beneficiary-friendly fliers and posters you can print out for your office. AFMC provider representatives will be visiting dental offices in person before November 1, 2024, to discuss the transition, provide job aids, Prior Authorization information, and contact information for the Provider Relations team and the MMIS billing team. AFMC will also be able to answer any specific questions providers may have.  

Question: I received information about Medicaid combining Delta Dental and MCNA. Is this accurate?

Answer: Medicaid is not combining Delta Dental and MCNA. The Dental Managed Care Program is ending, and we are returning our Dental Program to Medicaid fee-for-service. This means Medicaid clients will no longer be enrolled in Delta Dental or MCNA. Instead, Medicaid clients will use their Medicaid ID for Dental services, and Dental providers will bill Medicaid directly for services for Medicaid clients.

Other Questions

How can I ask a question that is not included in this set of FAQs?

If you have other questions, please email them to dentalproviderquestions@dhs.arkansas.gov.