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PROVIDER POLICIES AND PROCEDURES

Accessibility of Services

Advanced Directives Policy

Adverse Outcomes

Appointment Scheduling

Assigning of DCO Enrollees

Buy-ups and Enrollee Fee Responsibility

Billing of Other Preventive Services

Care Coordination

Chart Audits

Code of Conduct

Communication Services

Comorbidity

Compliance Program

Confidentiality

Conflict of Interest

Credentialing and Recredentialing

Cultural Responsiveness Training

Dental Records

Disenrollment from DCO

Dismissal of Member from Practice

Early Childhood Caries Prevention (ECCP) Protocol

EHR System

Emergency Services

Encounter Data Audit

Enrollee Correspondence

Enrollee Grievance and Appeals

Enrollee Information and Education

Enrollee Rights and Responsibilities

Flexible Services

Health Related Services

Hospital Dentistry

Hospital Emergencies

Inter-Rated Reliability

Mandatory Abuse Reporting

Medicaid Program Integrity-Fraud, Waste and Abuse

Member Rights Communication

Member Services

Moral Objections Policy

Network Adequacy Policy

Non-Discrimination

Notice of Adverse Benefit Determination

Oral Hygiene Instructions and Tobacco Cessation

Out of Network Services

Over and Under Utilization

Pain Medication Policy

Patient Records

Policy and Procedure Protocol

Practice Guidlines

Pre-Authorization

Privacy

Provider Credentialing Appeal Rights

Provider Directory

Provider Training

Quality Assurance Program

Referrals

Seclusion and Restraint

Second Opinion

Third Party Recovery

Timely Access Monitoring

Tobacco Cessation

Transition of Care

Transportation

Treatment Planning and Documentation

Utilization Management Processes to Avoid Conflict of Interest

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Advantage Dental The Advantage Community
Corporate Office
442 SW Umatilla, Suite 200, Redmond, OR 97756
P 541 504 3900 | F 541 504 3907

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