Provider Training

Basic seminars address general program purpose, goals, policies and procedures. In addition, the seminars provide instructions for the correct use of standard billing forms and explain the reference materials and support services available to Medi-Cal Dental providers.

The EDI section of the presentation includes an overview of TAR and claim submissions, review and retrieval of reports, EDI label preparation and mailing of TARs and claims and the submission of electronic attachments.

A Provider Relations Representative conducts the four (4) hour Basic Seminar and each attendee may receive three (4) Continuing Education credits by completing this seminar. This seminar provides a description of general program policies and procedures for dentists, hygienists, and staff new to the Medi-Cal Dental Program. The seminar topics are as follows:

• Medi-Cal Dental Program enrollment requirements.
• How to apply for Direct Deposit.
• What to do if using a Billing Intermediary.
• How to access the Point of Service (POS) Network.
• Discuss commonly billed procedure codes and how to complete forms for billing.
• Discuss member eligibility.
• How to request First Level Appeals.
• How to process claims for California Children's Services (CCS), Genetically Handicapped Persons Program (GHPP), and hospital cases.
• How Medi-Cal/Medicare crossover codes and other support services are used within the Medi-Cal Dental Program.
• Classes contain National Provider Identifier (NPI) and an Electronic Data Interchange (EDI) overview.

Advanced seminars offer in-depth information on topics such as Medi-Cal Identification Cards, dental criteria, x-ray and documentation requirements, processing codes, and other topics of specific concern to Medi-Cal Dental providers.

A dental consultant conducts the four (4) hour Advanced Seminar and each attendee may receive four (4) units of Continuing Education by completing this seminar. This seminar includes an in-depth description of general program policies and procedures for dentists, hygienists, and staff new to the Medi-Cal Dental Program. The seminar topics are as follows:

• Medi-Cal Dental Program enrollment requirements.
• Medi-Cal Dental Program procedure codes and radiograph requirements.
• Member eligibility.
• Medi-Cal/Medicare Crossover Codes.
• Pre-paid Health Plan claims.
• Discuss commonly billed procedures such as Periodontics, Endodontics, Oral Surgery, Crowns, and Prosthodontics.
• Viewing of treatment slides.

Specialized training seminars have been developed for orthodontists who participate in the Medi-Cal Dental Orthodontic Services Program. These seminars cover all aspects of the Medi-Cal Dental orthodontic program, including enrollment and certification, completion of billing forms, billing procedures and criteria and policies specific to Medi-Cal Dental orthodontic services.

A Provider Relations Representative conducts the four (4) hour Ortho Seminar and each attendee may receive three (4) Continuing Education credits by completing this seminar. This seminar provides a description of general program policies and procedures for dentists, hygienists, and staff new to the Medi-Cal Dental Program. The seminar topics are as follows:

• Designed for Medi-Cal Dental providers who limit their practices to orthodontics only.
• Comprehensive information on certification, enrollment, billing procedures, and criteria.
• Program procedures and policies specific to the provision of the Medi-Cal Orthodontic services.

Workshops provide the inexperienced billing staff a hands-on opportunity to learn about the Medi-Cal Dental Program.

The Workshop is six (6) hours long and offers six (6) Continuing Education credits upon completion. This workshop provides the inexperienced billing staff a "hands-on" opportunity to learn about the Medi-Cal Dental Program. The workshop topics are as follows:

• Understanding the Medi-Cal Dental Program enrollment, certification, criteria and policies and procedures.
• How to complete and submit claims and Treatment Authorization Requests (TARs).
• Direct Deposit participation.
• The Automated Eligibility Verification System (AEVS).
• How to bill for commonly used procedure codes and complete other miscellaneous forms.
• How to provide member services for California Children's Services (CCS), Genetically Handicapped Persons Program (GHPP), hospital cases, and processing claims.
• Health Insurance Portability and Accountability Act (HIPAA).
• Other support services.