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TO:                  Dental Providers


FROM:            Kathleen P. Allyn, Deputy Administrator


This Information Release (IR) reflects a change in Medicaid Policy previously issued in IR 2003-87 concerning mandatory use of ADA 1999 (2000) red ink claim form.

Numerous dental providers who bill on paper claims have contacted Medicaid to voice their concerns about Information Release 2003-87, and indicated that changing their billing systems to the red ink ADA 1999 claim form would create significant financial and staffing impacts on their dental practices. Therefore, in response to the concerns of our dental providers, Idaho Medicaid will continue to encourage, but will not mandate, the use of the ADA 1999 (2000) red ink claim form for paper claims on January 1, 2004.

You may bill dental claims using the following options, in order of efficiency: 

1.      Electronic billing is the quickest and most accurate way to submit Medicaid claims. Providers who are not set up to bill electronically may contact an EDS Provider Services Representative for more information toll-free at 1-800-685-3757, or 383-4310 in the Boise area.

2.      Paper claims billed on the red ink ADA 1999 (2000) claim form can be scanned and processed more quickly than other paper claim forms.

3.      Paper claims may be billed on the ADA 1999 (2000) claim form printed in black ink, including software-generated claim forms which print on plain paper.

4.      Paper claims may also be billed on ADA dental claim forms older than the ADA 1999 (2000), however these claims require a longer period to process as they must be manually data-entered by EDS.

Please note that Medicaid still cannot accept paper claims on the ADA 2003 claim form because it does not contain all the required fields needed for processing.

Any questions about this Information Release should be directed to EDS at 1-800-685-3757 or 383-4310 in the Boise area.

Thank you for discussing your issues and concerns with Medicaid and for your continued participation in the Idaho Medicaid Program.