| Referrals
are required for services considered to be specialty treatments.
The following is a brief explaination of specialty guidelines
of the Access Dental Plan. The Primary Care Dentist requesting
the referral must submit an Access specialty referral form. You
can obtain this form under Provider
Forms.
Decisions
authorizing referrals for specialty services are based on information
provided by your office to Access Dental Plan. Access' Dental
Consultants make the final decisions regarding authorization
for specialty services. The Dental Consultant or his/her designee,
who is a California licensed dentist, reviews all referral decisions
requiring professional judgment, including all potential denials.
Referrals
are valid for 60 days from the date of approval by Access.
You
can review details of the specialty referral guidelines below:
·
Regular Specialty Referrals
·
Emergency Specialty Referrals
· Timelines
for Referrals
·
Specialty Referrals by Category
·
Referral Follow-up
·
Denial of Referral Due to Inadequate
Information
·
Second Opinion
If
you need further information regarding the referral guidelines,
please Contact Us by phone or email
and we will be glad to assist you.
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