Hurricane Ian Disaster Grace Period

Following the landfall of Hurricane Ian, the Federal Emergency Management Agency (FEMA) issued a major disaster declaration for the following Florida counties affected by Hurricane Ian (DR-4673-FL): Brevard, Charlotte, Collier, DeSoto, Flagler, Glades, Hardee, Hendry, Highlands, Hillsborough, Lake, Lee, Manatee, Monroe, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns, and Volusia. A “disaster grace period” has been set by the Florida Agency for Health Care Administration (AHCA) from September 29, 2022, through November 30, 2022.

MCNA cares about the communities we serve and want to ensure our members continue to have access to all medically necessary dental care and services they need. We have established a claims exception process and removed prior authorization requirements in support of this goal. During the disaster grace period, the following applies in only the FEMA-designated counties listed above:

• Claims should continue to be submitted to MCNA through the regular claims submission process. Any service code that does not require prior authorization will not require additional documentation to be processed.
• Any service code that requires prior authorization will not be automatically denied due to lack of pre-authorization on file. Ensure all required documentation is submitted with the claim. A Clinical Reviewer will review and make determinations for these claims.
• All claims must be for services covered by Florida Medicaid. And the following claims submission requirements apply:
  • Member Name
  • Member ID Number
  • Member and/or Guardian Signature (or Signature on File)
  • Member Date of Birth
  • Description of Services Rendered
  • Provider NPI Number
  • Provider Name, Signature, Office Address, Office ID Number, Phone Number, and State License Number
  • Proper CDT Coding with Tooth Numbers, Surfaces, Quadrants, and Arch (when applicable)
  • Full mouth series x-ray, bitewings, and/or periapical x-rays (when needed)

• Any service code that does not require prior authorization will not be automatically denied due to provider enrollment status (i.e., non-participating provider) and will require submission of a claim to MCNA that includes a minimum documentation of medical necessity.
• Service codes that require prior authorization and that are received from non-participating providers will not be automatically denied due to lack of pre-authorization on file or provider enrollment status. Ensure all required documentation is submitted with the claim. A Clinical Reviewer will review and make determinations for these claims.
• Additionally, MCNA needs at a minimum the following information from non-participating providers to process claims:
  • Provider NPI Number
  • Provider Name
  • Office Name and Address
  • Phone Number
  • Tax ID
  • Provider License Number
• Non-participating Florida and out-of-state providers must apply for an emergency Medicaid ID through AHCA’s secure online web portal at http://portal.flmmis.com/flpublic/.
• Reimbursement will be in accordance with AHCA’s Dental Reimbursement Schedule.

• MCNA maintains all service code documentation requirements in our Florida Medicaid Provider Manual, which is available for download from https://manuals.mcna.net/florida.

• If you have questions about these claims exception and expedited prior authorization processes, please contact our dedicated Florida Provider Relations team via email at prdepartment@mcna.net. You may also call our dedicated Florida Provider Hotline at 1-855-698-6262 (8 a.m. to 8 p.m., ET).