Adult Dental Expansion

By December 31, 2022: Billing team must update all systems and provider workflows to reflect the new Maryland Medicaid adult dental benefit expansion. (1) Remove the $800 annual maximum from billing rules for Adult Dental Pilot Program participants transitioning to the expanded benefit. (2) Update claim submission logic to remove copayment and cost-sharing requirements for all Medicaid-eligible adults age 21+ on full Medicaid benefits. (3) Configure billing software to recognize and process claims for all newly covered dental service categories (preventive, restorative, diagnostic, endodontics, periodontics, oral surgery, prosthodontics, emergency services) without prior authorization denials based on benefit limitations. (4) Communicate to all dental providers and front desk staff that the Adult Dental Pilot Program ends December 31, 2022, and the expanded benefit begins January 1, 2023. (5) Verify that encounter forms and patient eligibility checks reflect the new benefit structure. Failure to implement these changes will result in claim denials for the expanded services and incorrect patient billing.