If a situation occurs where a resident needs dental care between the regularly scheduled dental visits the following procedure should be followed:
1. Call Senior Dental Care to discuss the situation regarding the resident. This is important so that SDC can document this in the patient’s files and will determine the best course of action.
2. If the resident needs to see a dentist immediately and must be transported to a local dentist, the insurance will pay for out of network benefits.
3. For the remaining amount that the insurance does not pay, Citizens Security Life Insurance Company will provide the insured with an Explanation of Benefits (EOB) covered showing a balance so that the facility can apply for a Medicaid offset for the remaining balance. The EOB should be sent to the facility if the facility receives the resident’s check. The EOB will be sent to the family if the family receives the resident’s check.