Delta Dental Insurance
Texas Children’s Medicaid and CHIP Dental Services
Announcements
- Important Message for Members and Providers from HHSC
- Effective immediately through May 31, 2012, HHSC will allow all members to receive care from any network provider. This additional time will ensure members have no disruption in care and allow members to contact their dental plan to choose their Main Dentist. Providers are not required to request a referral during this time. Providers should continue to see and provide care to their patients and will be reimbursed for all covered dental benefits.
- Value-Added Services for Program Members
- New Medicaid and CHIP members can order a free dental care kit and mouth guard (available for ages six to eighteen). Please call us if your Medicaid or CHIP patient needs help ordering their free kit or mouth guard.
Essential Documents
- Provider Manual – New March 2012 PDF, 4.83MB
- Texas Medicaid Orthodontic Services PDF, 78KB
- Texas CHIP Fee Schedule PDF, 12KB
- Texas Medicaid Fee Schedule PDF, 58KB
Applications: Support Texas Medicaid and CHIP Programs
- Texas Medicaid and CHIP Application PackagePDF, 930KB
- Texas Medicaid and CHIP FQHC Application PacketPDF, 910KB
Seminars and Training
- Provider Seminar Schedule PDF, 36.7 KB
- Online Texas Medicaid/CHIP Dental Services Presentation PDF, 1.83 MB
- Online Cultural and Linguistic Training Presentation PPT, 3.36MB
Other Documents
- Texas Medicaid and CHIP Change Main Dentist FormPDF, 26KB
- Texas Medicaid Out of Network Referral Request FormPDF, 85KB
- Texas Medicaid Orthodontic Criteria FormPDF, 33KB
- Texas Medicaid Orthodontic Continuation of Care FormPDF, 24KB
- Texas CHIP Orthodontic Continuation of Care FormPDF, 20KB
- Texas Medicaid General Anesthesia FormPDF, 35KB
- Texas Medicaid Claim Inquiry FormPDF, 69KB
- Texas CHIP Claim Inquiry FormPDF, 69KB
- Texas CHIP Complaint FormPDF, 64KB
- Texas CHIP Appeal FormPDF, 68KB
- Texas CHIP Fraud, Waste and Abuse FormPDF, 33KB
- Texas Medicaid Complaint FormPDF, 21KB
- Texas Medicaid Appeal FormPDF, 24KB
State Program Provider Bulletins
- 2012 Bulletins
- Spring276KB
- 2011 Bulletins
- 2010 Bulletins
Other Delta Dental Documents
- Billing Provider Information Change Form PDF, 19KB
- Direct Deposit Form PDF, 188KB
- Electronic Data Agreement Form PDF, 110KB
- National Provider Identifier (NPI) Form PDF, 54KB
- Texas CHIP Private Pay Agreement FormPDF, 21KB
- Texas Medicaid Private Pay Agreement FormPDF, 21KB
- Texas CHIP Eligibility Verification Form PDF, 58KB
- Texas Medicaid Eligibility Verification Form PDF, 57KB
- Treating Provider Information Add/Change/Termination Form PDF, 33KB