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 37 November 2006 TO: Dental Providers Participating in MassHealth FROM: Beth Waldman, Medicaid Director RE: New Start Date for Dental Third-Party Administrator (TPA) - February 1, 2007 TPA Update This bulletin is to inform you of a change in the operational start date for the Dental Third-Party Administrator (TPA) conveyed in Dental Bulletin 36. The new start date is February 1, 2007. Please refer to Dental Bulletin 36 (September 2006) for complete information about the services to be administered by the TPA, some of which are briefly repeated here. Information about the TPA Dental Services of Massachusetts, Inc. (DSM) is the vendor chosen by the Commonwealth to serve as the TPA. DSM is subcontracting with Doral Dental USA, LLC, a company that has experience administering Medicaid dental programs in many states. __________________________________________________________ Program Improvements The TPA will provide a new service to both members and providers called Intervention Services. As part of this service, your referred members can receive education on subjects such as the importance of making and keeping dental appointments, dental office procedures, follow-up treatments, and good oral-hygiene practice. The TPA will also offer many Web-based services for providers, such as claim status inquiries, registering for regional training sessions, requesting assistance, downloading member educational materials, and submitting prior- authorization requests and X rays electronically. (continued on next page) ________________________________________________________ Electronic Transactions The TPA will support all current HIPAA-compliant transactions such as claims and eligibility verification. In December 2006 and January 2007, those providers who submit claims electronically will be contacted to test their claims submissions. Effective February 1, 2007, 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. What You Need to Do Please watch your mail for introductory information from DSM including the dates and times for upcoming training sessions during the month of December. Providers should also make every effort to submit outstanding dental claims as soon as possible to ease the transition to the TPA. __________________________________________________________ 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. MassHealth Dental Bulletin 37 November 2006 Page 2