Adults with limited benefits may have received benefits incorrectly
Claims have incorrectly paid for dentures/partials for adults with a limited benefits package. Dentures/partials of any kind are not a covered service for adults with a limited benefits package. Please reference the MO HealthNet Dental Manual, Sections 19.1.G(1) and (2), which states,” dentures/partials are coverable for children under 21 or for persons under a category of assistance for pregnant women, the blind or vendor nursing facility residents.”
Due to the incorrect payment of these claims, a mass adjustment will be initiated in the near future to correct this error. Please check all future remittance advices for the specific claims that were mass adjusted. In addition, we are requesting that you perform a self-audit to identify any incorrectly paid claims for dentures/partials for adults with a limited benefits package that may have paid during or after the mass adjustment process.