Referrals, predeterminations and additional treatments
We’re here to make sure Oregon’s Medicaid members have access to great dental care. We want to make sure you have everything you need to give them just that. Learn about making referrals and predeterminations. And, see our improved dental benefits.
Referrals
We offer verbal referrals for:
- Oral surgery
- Endodontics
- Pediatric dentistry
- Denturists
A referral is required for:
- Periodontics
- Special needs
- Second opinion
To find a Medicaid specialist in your area, search our Provider Directory. You can also call customer service at 800-342-0526.
Medicaid benefit improvements
The following benefits are available for our members:
- Stainless steel crowns for molars are covered — for all members
- Full dentures are covered once every 10 years, instead of once per lifetime, regardless of when the last tooth was extracted
- Partial dentures are covered once every 5 years
- Periodontal maintenance is covered once every 6 months
- Periodontal scaling and root planing is covered once every 2 years
Predeterminations
To help prevent treatment delays and provide more benefits, we offer predetermination services just for partial dentures, endodontic services and oral surgery. Predeterminations are optional. They are not a guarantee of payment. Additionally, you are not required to advise ODS Community Dental of the final restoration for root canal treatment.
Additional dental treatments
If you have a Medicaid patient that has a healthcare need or comorbid condition that requires them to have additional dental treatment, please send a letter and supporting chart notes to:
Attention: Dental Correspondence
601 S.W. Second Ave
Portland, OR 97204
Updated as of July 1, 2016, for our dental Medicaid providers
Contact us
We’re here for you, and we want to help.