ILLINOIS MEDICAID
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DentaQuest provides dental coverage to adults, pregnant women and children who are eligible for Illinois Medicaid and are members of All Kids and HFS Adult Dental Program.
Member Benefits
Prevention
- Oral exam (every six months for children and every 12 months for adults)
- Teeth cleaning
- X-rays every 12 months
- Fluoride treatments
- Sealants (age requirements apply)
Treatments
- Crowns
- Root canals
- Extractions (teeth removal)
- Other medically necessary care
Additional
- Emergency dental care
- Orthodontia (braces) (age requirements apply)
- Teledentistry
NOTA: el resumen de beneficios anterior se incluye solo con el fin de brindar información adicional y es posible que no refleje todas las actualizaciones o modificaciones a los beneficios del plan. Contáctenos para confirmar sus beneficios actuales.
Important Plan Documents and Information
Customers may submit complaints to DentaQuest telephonically or in writing on any HFS Dental Program issue other than decisions that deny, delay, reduce, or terminate dental services. Some examples of complaints include: the quality of care or services received, access to dental care services, provider care and treatment, or administrative issues.
If the Customer chooses to appeal the decision, a Customer Services Representative will assist by providing the information on how to initiate the appeals process.
The toll-free number to call to file a complaint is: (888) 286-2447
The address to file a complaint is:
DentaQuest of Illinois, LLC
Complaint Representative
P. O. Box 2906
Milwaukee, WI 53201-2906
Customers have the right to appeal any adverse decision DentaQuest has made to deny or reduce dental services.
A Customer may contact his/her caseworker for assistance in filing an appeal. In addition, DHS will help a Customer file an appeal.
Appeals must be filed within 60 days following the date the denial letter was mailed by DentaQuest.
Customers request a hearing by calling the Fair Hearings Section at 1-855-418-4421 (TTY: 1-312-793-2697 or 1-800-526-0857) or by fax at 1-312-793-2005 or by writing to:
HFS, Bureau of Administrative Hearings
401 South Clinton Street, 6th floor
Chicago, IL 60607
Appeals are reviewed by HFS under its existing administrative appeal procedure, and matters are heard before an Administrative Hearing Officer. DentaQuest approves and allows payment for any services ordered rendered by HFS or any Court of Jurisdiction, provided the Customer is eligible.
Contact Details
Plan Name: Illinois Health and Family Services (HFS)
Member Services: 888-286-2447
Hours of Operation: Monday through Friday, 8a–5p CT
Plan Website: Illinois Healthcare and Family Services
Fraud Hotline: 1-844-453-7283
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