Follow the steps outlined in the above section. If you have questions and would like to speak with an MCNA Dental representative, please call our Provider Hotline at 1-855-776-6262.

To stay up-to-date with all MCNA Dental news and announcements, you can periodically check our main news page on MCNA.net.

Important news and announcements exclusive to our network providers (including MCNA Dental procedure changes, change in Medicaid/CHIP dental rules, reminders about claims processing guidelines, etc.) will be posted on the main page of the Provider Portal once you log in to your account.

MCNA Dental sends monthly newsletters to all of our providers, delivered right to their email inboxes! These newsletters include the latest updates from MCNA Dental, information about upcoming changes, dental industry news, and much more. To sign up for these email newsletters, log in to the Provider Portal and add your email address to the mailing list.

The Pre-Authorization and Claims Submission Guide provides coverage criteria and prior authorization requirements in an easily searchable format. Call our Provider Hotline at 1-855-776-6262 for clarification about prior authorization requirements and assistance in submitting a prior authorization request.

Members may call the Member Hotline at 1-855-691-6262 to ask questions about the prior authorization process and obtain assistance in submitting a prior authorization request.

MCNA Dental sends monthly newsletters to all of our providers, delivered right to their email inboxes! These newsletters include the latest updates from MCNA Dental, information about upcoming changes, dental industry news, and much more. To sign up for these email newsletters, log in to MCNA Dental’s online Provider Portal and add your email address to the mailing list.

To view our recent provider newsletters, you may visit our Provider Resources and Documents section.

MCNA’s Dental Advisory Committee (DAC) is a nine-member group consisting of MCNA leadership and representatives of the Texas Dental Association (TDA), Texas Academy of Pediatric Dentists (TAPD), Texas Academy of General Dentists (TAGD), and the University of Texas Health Science Center School of Dentistry. The DAC meets on a quarterly basis to review benefit design, policies and procedures, and provider-related concerns. DAC members work with the HHSC to provide evidence-based recommendations to improve utilization rates and the delivery of oral health and dental care services, including prevention and education services and dental managed care. Please contact your local MCNA Provider Relations Representative or Dental Organization Representative for more information about MCNA’s Dental Advisory Committee.

Texas Health Steps’ online program offers free continuing education (CE) courses. These courses are designed to offer updated clinical, regulatory, and best practices guidelines regarding a range of oral health, preventive health, mental health, and case management topics.

To learn more and register for an online training session provided by the Department of State Health Services (DSHS), visit the Texas Health Steps Website.

MCNA’s payor ID is 65030.

You can view the MCNA Member Rights and Responsibilities as they appear for our members. A full list of MCNA Member Rights and Responsibilities can also be found in our Provider Manual.

MCNA facilitates access to dental services for non-English speaking members. We recognize that the diversity of our member population can serve as a barrier to accessing dental services. MCNA has adopted the recommendations set forth by the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards) as a guideline to developing our Cultural Competency Program.

To request more information about MCNA’s Cultural Competency Program and how it can help you provide culturally sensitive care to members, please call our Provider Hotline or send an email to qualityprogram@mcna.net. To learn about the National CLAS Standards, visit the U.S. Department of Health and Human Services Office of Minority Health website.

The Health and Human Services Commission (HHSC), MCNA Dental, and you, as a Medicaid dental provider, share the common goal of providing quality dental care and services to eligible Texans. Please read a Special Notice from the HHSC to learn more about your role in stopping Medicaid fraud in the State of Texas.

If you think a dentist or another MCNA member is doing something that could be fraud, waste, or abuse please report it to the Office of the Inspector General (OIG). You can make a report by going to the OIG website at https://oig.hhsc.state.tx.us/. You may also call the OIG Hotline at 1-800-436-6184.

You can submit a Medicaid or CHIP complaint by calling our Provider Hotline at 1-855-776-6262or by sending an email to TX_PR_Dept@mcna.net. Send a written complaint to:

MCNA Dental
Attn: Complaints Department – Provider Relations
P.O. Box 29008
San Antonio, Texas 78229

Fax: 1-210-745-4264

If you have exhausted MCNA’s complaint process and are still not happy, you may submit a complaint directly to the HHSC using the following email address: HPM_Complaints@HHSC.state.tx.us.

MCNA encourages you to contact the Provider Hotline if would like to file an appeal with us. Our representatives will discuss the process with you. All appeals must be submitted in writing to:

MCNA Dental
Attn: Appeals Department – Provider Appeals
200 West Cypress Creek Road, Suite 500
Fort Lauderdale, Florida 33309

Email: TX_PR_Dept@mcna.net
Fax: 1-210-745-4264

The Vendor Drug Program (VDP) provides statewide access to covered outpatient drugs for individuals enrolled in Medicaid, CHIP, the CSHCN Services program, the HTW program, and KHC program. The cost for drug prescriptions in the Texas Medicaid program is shared by the federal government and the state. In order for Texas to receive federal funds assistance for prescription claims, any drugs prescribed must be produced by a drug manufacturer that participates in the Centers for Medicare & Medicaid Services (CMS) drug rebate program. In return for having their drugs covered by state Medicaid programs, the manufacturer agrees to pay rebates according to their state and federal contracts. VDP oversees the collection of these rebates from drug manufacturers.

Visit the VDP website for more information. You can also search the formulary and view the Preferred Drug List.