Current through Vol. 42, No. 1, September 16, 2024
(a)
Definition.
"Mobile dental unit" means a motor
vehicle or trailer that contains dental equipment and is used to provide dental
services to eligible SoonerCare members on-site in accordance with Title 59 of
Oklahoma Statutes (O.S.), Section
328.3 (59 O.S.
§328.3).
(b)
Eligible
providers. For dental services provided at a mobile dental unit to be
eligible for SoonerCare reimbursement, a dental group shall meet all applicable
requirements set forth in the Oklahoma Board of Dentistry rules, the Oklahoma
State Dental Act (59 O.S., Ch. 7), and the requirements in this Section,
including but not limited to, all licensing and permitting requirements.
(1) All dentists working at a mobile dental
unit shall be currently licensed in good standing with the Oklahoma Board of
Dentistry. All other contracted providers of the dental group, working at a
mobile dental unit, shall meet all credentialing/certification requirements, as
per their specialty. In addition, all members of the dental group working at a
mobile dental unit shall comply with the requirements at Oklahoma
Administrative Code (OAC)
317:30-5-695.
(2) The license, certification,
accreditation, and/or permit (or a photocopy of these documents) of every
individual provider in the dental group shall be prominently displayed at the
mobile dental unit, pursuant to 59 O.S., Section (§) 328.21.
(3) For services provided in a mobile dental
unit, the permit to operate the mobile dental unit shall be prominently
displayed in the mobile dental unit vehicle, pursuant to 59 O.S.
§328.40a.
(4) In accordance
with OAC 317:30-5-695.1, every dental
group providing services at a mobile dental unit must be fully contracted with
the Oklahoma Health Care Authority (OHCA) as a dental group provider and must
also be fully contracted with OHCA as a mobile dental unit.
(5) Every individual dentist practicing at a
mobile dental unit must be fully contracted with the OHCA as a
dentist.
(6) Dental groups and
individual providers providing dental services at a mobile dental unit shall
comply with all applicable state and federal Medicaid laws, including, but not
limited to, OHCA administrative rules, the Code of Federal Regulations, and the
Oklahoma State Medicaid Plan.
(c)
Coverage. Refer to OAC
317:30-5-696 for dental coverage
descriptions for children and adults.
(d)
Description of services.
Mobile dental units must treat both children and adults and provide urgent,
preventive, and restorative dental services that are appropriate to provide in
this setting.
(1) All current dental rules at
OAC 317, Part 79, still apply to all mobile dental services including, but not
limited to, prior authorizations, medically necessity criteria, documentation,
and limitations.
(2) Endodontics,
orthodontics, prosthodontics, periodontics, and permanent crowns will not be
covered in mobile clinic.
(3)
Mobile dental units will be required to refer a member to a SoonerCare
contracted dental provider for any follow-up care when needed or to access
services that cannot be provided in the mobile unit.
(e)
Limited provider service
area. Mobile dental units should serve members in SoonerCare dental
provider shortage areas. Dental provider shortage areas mean Oklahoma counties
that have less than ten (10) Medicaid general dental providers.
(f)
Billing and reimbursement.
Billing and reimbursement policies in accordance with OAC
317:30-5-704 through
317:30-5-705 apply to mobile
dental services.
(g)
Post
Care. Each member receiving dental care at a mobile dental unit must
receive an information sheet at the end of the visit. The information sheet
must contain:
(1) The name of the dentist,
dental hygienist, and/or dental assistant who provided the dental services at
the mobile dental unit;
(2) Valid
contact information which can include a business telephone number, email
address and/or other emergency contact number for the dental group and/or
dentist that provided the dental services at the mobile dental unit;
(3) A listing of the treatment rendered,
including, when applicable, billing codes, fees, and tooth numbers;
(4) A description of any follow-up treatment
that is needed or recommended; and
(5) Referrals to specialists or other
dentists if the mobile dental unit providers were unable to provide the
necessary treatment and/or additional care is needed.
(6) All dental records including radiographs
from that visit should be provided to the member and/or forwarded to the dental
provider providing follow-up care. Electronic and/or printed forms of records
are acceptable.
