West Virginia Dental Providers

The following message is from the Bureau for Medical Services:

Effective April 1, 2011, the UMC forms and prior authorization requirements contained in Chapter 505 Dental Services manual effective 11/1/10 will be in place. Previous UMC forms will not be accepted after April 1, 2011 and all services requiring prior authorization in the updated manual will now be subject to review by WVMI.

Currently, the WVMI will continue to accept the UMC forms by fax or mail. We are pleased to announce that in the coming months IRG d.b.a. APS Healthcare, Inc. will be introducing a Direct Data Entry (DDE) format for submission of all UMC forms. This format is expected to improve the provider’s ability to submit forms for member services and improve timelines for submission and response to prior authorization requests. While UMC forms can continue to be faxed or mailed to WVMI in future; it is expected that the DDE system can reduce the time required to obtain prior authorization for dental services for Medicaid members. As the subcontractor to IRG d.b.a. APS Healthcare, Inc., WVMI will continue to review dental prior authorization requests as they have done in the past.

Additional materials, training notices and information about timelines for the transition will be posted on the WVMI and APS Healthcare, Inc. websites as well as through various dental associations and Molina, the claims payer.

• Dental Changes Notice April 1, 2011
• BMS UMC Dental Forms
  
• Dental Retrospective Review
• FAQs