Dental Blog -- Dental Opinions and Reviews, Dental Insurance Plan Reviews - Dentist, Dental Office Consumer Opinions and Customer Complaints

Dental Opinions is a service to the dental insurance community providing dental reviews and opinions for dental insurance plans, dental plan procedures, dentist, and the various dental plans sold on the internet such as dental discount plans, reduced dental fee for service, PPO dental insurance plans, DHMO, and dental insurance indemnity products for individual and family dental plans.

Call Us Today Monday - Friday 8am - 4pm

(310) 534-3444

Consumer website reviews of good, bad, and ugly dentistry. Advocates for dental fairness.


Is Denti-Cal a dental care segment of the Medi-Cal program?

Posted on Tuesday, Dec. 15th 2009 8:00 AM by Dental Plan Review in Dental Help, Dental News, Dentists, General News Comments Off on Is Denti-Cal a dental care segment of the Medi-Cal program?

Denti-Cal is the dental care segment of the Medi-Cal program. Denti-Cal is administered by a private managed care plan, Delta Dental. Delta Dental’s primary function is to process claims and treatment authorization request (TARs) submitted by providers for dental services performed for Medi-Cal beneficiaries. The most recent contract between California Department of Health Services (DHS) and Delta Dental was signed in 1998.

Eligibility, administration and scope of services is governed by Welfare and Institution Code 14000 et seq. And Title 10 and Title 22 of the California Code of Regulations. Additional guidance about the program is provided in the Denti-Cal Provider Manual.


Individuals who are enrolled in the Medi-Cal Program are eligible to receive dental services provided by Denti-Cal. Eligibility is verified through presentation of a Beneficiary Identification Card, known as a BIC card. Certain limitations in access to dental services may apply to the following beneficiaries:

1) individuals enrolled in prepaid health plan which provides dental services;

2) individuals enrolled in another pilot program which provides dental services;

3) individuals who are assigned special aid codes; 4 individuals with minor consent restricted cards.

Upon verifying eligibility in Medi-Cal, a provider cannot bill a beneficiary for any part of the charge for a Medi-Cal covered service, except to collect copayments or share of cost. Providers can request payment of share of cost. Additionally, providers can input information about incurred medical expenses into the AEVS system (Automated Eligibility Verification System), which can help a beneficiary satisfy his/her share of cost obligation.


Generally, Denti-Cal covers inpatient and outpatient services “which are reasonable and necessary for the prevention, diagnosis, and treatment of dental disease, injury or defect.” A number of dental services, including emergency and diagnostic services, including examinations, radiographs, biopsies and dental prophylaxis, are covered without prior authorization. Denti-Cal services are provided through fee-for-service as well as managed care arrangements. In the fee-for-service system, beneficiaries can access any dental provider who participates in Medi-Cal in their geographic area. In managed care, beneficiaries are restricted to those providers participating in the dental plan.

Additionally, in the fee-for-service system, approval of some services must be sought through a Treatment Authorization Request (TAR). In managed, care approval of certain services is provided by the health plan through its pre-authorization process. Some services, such as cosmetic procedures, experimental procedures that increase vertical dimension or restore occlusion, are excluded from coverage by Denti-Cal.


Posted on Tuesday, Dec. 15th 2009 8:00 AM | by Dental Plan Review | in Dental Help, Dental News, Dentists, General News | Comments Off on Is Denti-Cal a dental care segment of the Medi-Cal program?


Dental review keywords to help you find us again. brings you content on these related dental items.

dental plan reviews, dental plans review, dental plan review, dental discount plan reviews dentist reviews, dentists reviews, dentist review, dentistry reviews, cosmetic dentist reviews, dentists review, dental reviews, dentist ratings reviews, cosmetic dentistry reviews, pediatric dentist reviews, a dentist reviews, dentist and reviews, dentist reviews in, dentist reviews in new, dentist reviews new, reviews for dentist, reviews of dentist in, reviews on dentist in, dentist net reviews, reviews of dentist, free dentist reviews, dentist reviews las, reviews on dentist, dentist and review, dentist net review, dentist review in, review a dentist, review for dentist, review of dentist, dentist review new, review of dentist in, dentistry review, dentist reviews long, review on dentist, reviews for dentist in, cosmetic dentist review, reviews of dentists, dentists reviews in, reviews on dentists, reviews for dentists, dental review, dentist patient reviews, dentist patient review, review of dentists, dentists review in, city dentist reviews, dental dentist review, best dentist reviews, city dentist review, patient reviews of dentists, family dentistry reviews, patient reviews of dentists in, reviews of dentists in, reviews on dentists in, cosmetic dentistry review, family dentistry review, dental hygiene reviews, review of dentists in, area dentist reviews, gentle dental reviews, dentist reviews orange, dentist reviews dr, dentist reviews nyc, dentist review dr, dentist review nyc, dds dentist reviews, new york city dentist reviews, dentist reviews los, reviews for dentists in, dds dentist review, gentle dental review, area dentist review, dental arts reviews, dentist reviews cincinnati, dentist reviews st, dentist review los, md dentist reviews, dentist reviews columbus, las vegas dentist reviews, dentist review st, tucson dentist reviews, dental arts review, dentist reviews milwaukee, dentist reviews arlington, pediatric dentist review, dentist reviews pasadena, pasadena dentist review, dentist reviews boston, dental associates reviews, dentist review boston, dental associates review, comfort dental reviews, dentist reviews orlando, comfort dental review, dental patient reviews

Copyright 2011 All rights reserved. DEL AMO Insurance Services, Inc.