VOL 65 | APR 2022 | QTR 2
TEXAS ROUNDUP
IN THIS ISSUE
Texas Medicaid and Texas CHIP members can now change their Main Dental Home provider online on the Change Your Main Dentist page. As a reminder, Main Dentist changes can only be made by the Member’s head of household.
• Make changes online, faster than a call, 24/7
• No need to log into the Member portal
• Use the same system our Member Services team uses
• Members show up on your patient roster within minutes - no reference number needed!
Member’s Head of Household Can Use This Code to Change Main Dentist Now!
DentaQuest is currently collaborating with network dentists to move dental care in a more sustainable, collaborative direction through value-based care.
In a value-based system, quality and outcomes should improve while costs remain the same or fall because the healthier a person is, the less they require expensive services. We know people are both in need of dental care and concerned about the cost of care — just as before the pandemic. We process claims for services delivered in response to an already present dental disease. Fillings and extractions address the impact of disease but do not address or eliminate its cause. Said another way, restorative care is more costly to the system and the person, while preventive care is more valuable for people and communities.
If you would like more information regarding DentaQuest’s value-based care model, please contact your regional Provider Relations Contact.
Last month, a water main break cut off clean water from more than half of Laredo’s residents. With her community in crisis, Anel Torres, a member advocate specialist for DentaQuest in Texas, took matters into her own hands.
Anel’s reached out to DentaQuest corporate giving, which purchased roughly $5,000 of bottled water — nearly 17,000 16-ounce bottles — and had them delivered directly to Anel’s home all within a few days.
Anel, in partnership with the Mid Rio Grande Border Area Health Education Center, arranged a water distribution drive thru from her home and door-to-door delivery. Both organizations also provide literacy, health education, economic and community development support.
As a result of Anel’s call for resources and DentaQuest’s prompt response, over 200 families in Laredo, Texas received clean drinking water. DentaQuest is grateful for her act of kindness, truly living the mission to improve the oral health of all.
View the news coverage about Anel's contribution to her community: Laredo woman lends helping hand during water crisis.
In 2019, DentaQuest launched the new interactive Texas provider portal which offers features to help simplify everyday tasks and allows providers to focus on delivering quality member care. If your office is not utilizing the provider portal, please visit the provider portal sign in page or complete the registration process.
If you have any questions regarding the Texas provider portal or the self-registration process, please contact your regional Provider Partner.
Referrals from a Main Dentist to General Dentist/Pediatric Dentist for Interim Care
This process is to be utilized when a Main Dentist Dental Home provider (Main Dentist) determines that it is necessary for another Main Dentist (general or pediatric dentist) to provide interim care to a Member; yet the Main Dentist assignment should be maintained. Interim care transfers (ICTs) can be submitted via the DentaQuest provider portal. Each registered user has the capability to submit and view ICTs on the Provider Portal.
Although it has been 10 years since the introduction of code D1352 in the CDT 2011 Current Dental Terminology, questions remain on the proper coding of active carious lesions that do not extend into dentin. This serves as a primer on three current CDT Codes, and the indications for their use.
- Sealants, code D1351, are used to prevent decay and are used in deep pits and fissures. Sealants can reduce the risk of decay by nearly 80%.
- Preventive resin restorations (PRR), sometimes called conservative resin restorations or minimally invasive resin restorations are described by code D1352. PRRs are conservative restorations of an active cavitated lesion that does not extend into the dentin, placed in patients with moderate to high caries risk.
- Resin-based composites differ from PRRs in that they are used to restore carious lesions that do extend into the dentin. Per the code descriptor, this is not a preventive procedure.
Many dentists perform PRRs, or minimally invasive resin restorations but have been unclear on their proper coding. When removing decay and restoring a tooth, if the decay is confined to enamel and has not reached the dentin, the proper code is D1352. For additional information, please review the office reference manuals posted on the Provider Resources page.
The following documents are listed on the Provider Resources page:
- Office Reference Manuals
- Provider Training Schedule
- Quarterly Newsletters
In observance of the Memorial Day and Juneteenth holidays, DentaQuest will be closed on Monday, May 30, 2022 and Monday, June 20, 2022.
