Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA  02111
www.mass.gov/masshealth
	MassHealth
	Dental Bulletin 36
	September 2006 



	TO:	Dental Providers Participating in MassHealth

	FROM:	Beth Waldman, Medicaid Director

	RE:	New Dental Third-Party Administrator for MassHealth Providers and Members


New MassHealth Dental	As part of the Commonwealth’s commitment to increase access to dental
Third-Party	services for eligible members, MassHealth is pleased to announce that it 
Administrator	has signed a contract with Dental Service of Massachusetts, Inc. (DSM) to provide dental third-party administrator services.  MassHealth and DSM are currently in the process of implementing the contract with an operational start date of December 1, 2006.  You do not need to contract with DSM—your status as a MassHealth provider is not affected by this contract and MassHealth rates for dental services remain in effect.  

DSM is familiar with the Massachusetts marketplace and has commercial relationships with most dentists in the state.  DSM is subcontracting with Doral Dental USA, LLC, a company that has experience administering Medicaid dental programs in many states.

MassHealth views the combination of DSM’s local market knowledge and oral-health leadership and Doral’s government-based dental-administration experience as an important way of augmenting MassHealth’s other initiatives aimed at increasing access to dental services for MassHealth members.  

Some of the services to be administered for MassHealth include:
* claims processing;
* recruitment of new dental providers into the MassHealth dental program;
* credentialing of new MassHealth providers as well as recredentialing existing MassHealth dental providers;
* comprehensive customer service with a dedicated team specialized in dental care;
* responding to questions about claims, MassHealth eligibility, and benefit-authorization; and
* member placement (to help members find a dentist).

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Intervention Services	DSM will also provide a new service to both members and providers
	called intervention services.  Intervention services were developed by MassHealth and designed to assist you by working with eligible members who could benefit from education about the importance of making and keeping dental appointments, dental office procedures, follow-up treatments, or good oral-hygiene practice.  Intervention services specialists will also assist eligible members who need help scheduling an appointment or obtaining transportation to and from appointments.  


Other Program	DSM will also offer many Web-based services for providers, such as   
Improvements	making claim status inquiries, registering for regional training sessions, requesting assistance, downloading member educational materials, and submitting prior-authorization requests and X rays electronically.  In addition, members will be able to find a MassHealth-participating dentist by zip code.  


Electronic Transactions	DSM will support all current HIPAA-compliant transactions such as claims, eligibility verification, remittance information, claims status, and prior authorization.  In October and November 2006, those providers who submit claims electronically will be contacted to test their claims submissions.  DSM offers additional options for electronic submissions, including methods for submitting claim attachments electronically.  Effective December 1, 2006, the use of PCSS software to generate dental claims will no longer be accepted.  

	MassHealth will update its companion guides to reflect all changes to electronic transaction exchanges.  New versions of these documents will be posted on the MassHealth Web site at www.mass.gov/masshealth.  


Updated Information	MassHealth will continue to provide you with updated information about the TPA, including implementation, testing, and training schedules, through provider bulletins, remittance advice messages, and the MassHealth Web site.  Look for announcements about the TPA in the News & Updates box located on the right side of the screen at www.mass.gov/masshealth.  Please also watch your mail for introductory information from DSM during the month of October.


Questions	If you have any questions about the information in this bulletin, please call MassHealth Customer Service at 1-800-841-2900, e-mail your inquiry to providersupport@mahealth.net, or fax your inquiry to 617-988-8974.