Dental Program Administrator Services
Overview
Fit Score
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SUMMARY
DESCRIPTION
The vendor is required to deliver dental program administrator services for fee-for-service customers enrolled in the Medical Assistance Program (MAP) in Illinois. The primary objectives include expanding access to comprehensive dental care, improving oral health outcomes, and increasing utilization of quality dental services through extensive provider enrollment and expanded service coverage.
Responsibilities encompass processing claims, submitting encounter data, handling service authorization requests, offering customer service to both clients and providers, assisting with dental appeal hearings, preparing necessary reports, and maintaining a provider enrollment system with an accurate and updated database. For medical program customers under age 21, dental services are mandated as part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. The contract will have a five-year duration.
Source attribution
This Settle analysis is based on the issuing organization’s public RFP listing.