1. Organizational Overview Executive Summary Corporate background and experience Brief history, ownership structure, and experience in administering Medicaid dental programs States currently serving as a dental TPA 2. Scope of Work Description of available services related to dental benefit administration Capacity to implement and manage large-scale dental programs Timeline to implement with a state Medicaid agency 3. Network Management Approach to recruiting and retaining dental providers, including specialists Strategies for increasing provider participation in underserved areas 4. Enrollee Services • Description of administrative functionality to address beneficiary concerns and awareness of dental benefits. • Describe resources for beneficiaries to access plan information, benefits, locate dentist and review claim history • Capabilities to operate a beneficiary call center for the above-mentioned services and care coordination. 5. Claims Processing and Utilization Management Capabilities for timely and accurate claims adjudication Utilization review and cost containment strategies Description of service authorization process including clinical staffing requirements Capabilities to operate a provider call center for assisting with the above-mentioned services.
