Specifications include, but are not limited to: 1. DIVISION contracts with properly licensed dentists to provide dental services to service recipients as may be referred for services by DIVISION. The Awarded Vendor is expected to adhere to guidance set forth in the DMAP Dental Manual: https://medicaidpublications.dhss.delaware.gov/docs/search/EntryId/17 2. The Awarded Vendor will provide dental services consistent with applicable regulations, standards, and procedures governing the best practice of dentistry. 3. The Awarded Vendor determines the client’s dental status through dental examinations and diagnostic tests. 4. The Awarded Vendor will develop a dental treatment plan for each service recipient referred by the DIVISION based on industry-standard dental examinations and diagnostic tests. The treatment plan must include the following information for each recommended dental service: • dental procedure code • procedure code/service description • justification of need • tooth number • tooth surface, • Medicaid fee charged • invoice number All DIVISION service recipients served must have a dental treatment plan that is approved by DIVISION before any dental work can be performed. a. All treatment plans must be approved by the DIVISION prior to dental services being rendered under the plan. Awarded Vendors are required to submit treatment plans on the template attached as Appendix D. b. Treatment plans that recommend service code D999 must be itemized. c. If, during a visit using sedation, something is found that requires attention at that moment and it makes the treatment exceed $2,000, verbal approval should be sought from the Assistant Director of Community Services for DDDS/Contract Manager. d. Neither the DIVISION nor the individual will be responsible for services provided without an approved treatment plan.
