Dental Services
2.1.2. Scope of services includes, but is not limited to, the following:
2.1.2.1. Provide coverage of dental services to prevent disease and
promote oral health; restore oral structures to health and function;
and treat oral health emergency conditions;
2.1.2.2. Enroll, train and support a network of qualified dental providers
adequate to provide access to dental care for all members;
2.1.2.3. Maintain records for a minimum of six (6) years from date of
service;
2.1.2.4. Maintain quality control procedures and programs;
2.1.2.5. Furnish regular performance reports;
2.1.2.6. Operate separate toll free member and provider telephone hotlines;
2.1.2.7. Develop, implement and maintain a system for tracking and
resolving complaints and appeals of both members and providers;
and
2.1.2.8. Engage in dental education and member outreach campaigns at a
minimum annually, which may include reminders of the necessity
for periodic dental services. Campaigns at a minimum annually,
which may include reminders of the necessity for periodic dental
services.
