ua Medi-Cal Dental Managed Care
Rov qab mus rau Medi-Cal Dental Program Homepage
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) yog lub luag haujlwm los muab kev pabcuam kho hniav rau cov neeg tau txais txiaj ntsig Medi-Cal tsim nyog, thiab muab kev pabcuam los ntawm ob txoj kev xa khoom, Dental Fee-For-Service (FFS) thiab Dental Managed Care (DMC). Kev Kho Hniav FFS yog qhov kev xa khoom tshwj xeeb thiab thawj zaug muaj nyob hauv California 58 lub nroog. Txawm li cas los xij, xyoo 1995, raws li lub xeev txoj cai lij choj hloov pauv, DHCS tau siv DMC los tshawb txog qhov ua tau zoo ntawm DMC raws li kev xa cov kev pabcuam kho hniav. Tus qauv xa khoom DMC tam sim no ua haujlwm hauv ob lub xeev 58 lub nroog, Sacramento thiab Los Angeles. Hauv Nroog Sacramento, DMC tso npe kawm yog yuav tsum tau ua, nrog rau qee qhov kev zam. Hauv Nroog Los Angeles, tus neeg txais txiaj ntsig yuav tsum tau xaiv los koom nrog hauv DMC txoj haujlwm.
Lub Tsev Haujlwm tau cog lus nrog peb qhov Geographic Managed Care (GMC) Plans nyob rau hauv Sacramento County, thiab peb Prepaid Health Plans (PHP) hauv Los Angeles County uas muab kev pab kho hniav rau cov neeg tau txais txiaj ntsig Medi-Cal. Tag nrho cov phiaj xwm Medi-Cal DMC tau tso cai los ntawm Lub Xeev California, Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv, raws li Txoj Cai Knox-Keene Health Care Service Plan Act xyoo 1975. Cov neeg tau txais txiaj ntsig Medi-Cal DMC tau txais kev pabcuam kho hniav los ntawm cov kws kho mob hauv lub phiaj xwm kev pabcuam network. DMC cov kev pab cuam kho hniav yog tib cov kev pabcuam uas tau muab los ntawm Dental Fee-for-Service (FFS) Program.
Yog xav paub ntaub ntawv lossis nug txog qhov tshwj xeeb GMC thiab/lossis PHP kev npaj kho hniav, thov hu rau Plan tus xov tooj hu dawb uas teev nyob rau ntawm Managed Care Plan Directory webpage. Yog xav paub ntxiv txog Medi-Cal Cov Kev Kho Hniav Kho Hniav, thov mus saib hauv Medi-Cal Managed Care Health Care Options lub vev xaib.
Yog xav paub ntaub ntawv hais txog Dental Managed Care Directed Payment program, thov mus saib hauv Directed Payments webpage.
X12 274 x109 Kev Pabcuam Kev Noj Qab Haus Huv Directory Project
Tshaj tawm
Kev ntsuas kev ua tau zoo
Cov ntawv ceeb toom rau Pawg Neeg Saib Xyuas
DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau 2020 Kev Ua Haujlwm (Sau Lub Yim Hli 2021) DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau 2019 Kev Ua Haujlwm (Xa Lub Rau Hli 2020)
DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau 2018 Cov Haujlwm (Xa Lub Rau Hli 2019)
DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau Kev Ua Haujlwm 2017 (Xa Lub Yim Hli 2018)
DMC Daim Ntawv Qhia rau Cov Cai Lij Choj rau Kev Ua Haujlwm 2016 (Xa Lub Xya Hli 2017)
Daim Ntawv Qhia Txog Tus Neeg Tau Txais Kev Kho Hniav (BDE).
Txhawm rau saib BDE cov ntaub ntawv, thov mus saib ntawm BDE lub vev xaib.
Daim Ntawv Qhia Txog Kev Pom Zoo
Nco tseg: 42 CFR 438.332 xav kom lub xeev Medicaid cov koom haum ua kom muaj kev lees paub rau txhua qhov kev cog lus tswj hwm kev saib xyuas muaj nyob hauv lawv lub vev xaib. Raws li qhov yuav tsum tau ua, DHCS sau tseg tias tsis muaj ib qho ntawm Cov Kev Kho Hniav Tswj Xyuas Kev Kho Hniav tsis tau txais kev lees paub rau lawv cov Medi-Cal kab kev lag luam nrog lub koom haum ntiag tug uas muaj kev lees paub.
Kev Tshawb Fawb Txog Kev Tshawb Fawb
2025
DMC Pla n
| Cov hnub txheeb xyuas
| Kev Tshawb Fawb Tshaj Tawm
| CAP thiab DHCS teb
|
Access Dental Plan
| 4/21/2025 - 4/25/2025
| 2025 Audit Report
| |
2024
Access Dental Plan
|
3/18/2024 - 3/29/2024
|
2024 Audit Report
| Kaum Ob Hlis Ntuj 20, 2024
Npaj teb nrog CAP
Lub Ib Hlis 16, 2025
DHCS Teb rau CAP
Lub Ob Hlis 14, 2025
Npaj teb nrog CAP
Lub Peb Hlis 19, 2025
DHCS Teb rau CAP
Plaub Hlis Ntuj 18 , 2025
Npaj teb nrog CAP
Tsib Hlis 19, 2025
DHCS Teb rau CAP
Lub Rau Hli 18, 2025
Npaj teb nrog CAP
Lub Xya Hli 18, 2025
DHCS Teb rau CAP
|
Health Net ntawm California, Inc.
|
7/22/2024 - 8/2/2024
|
2024 Audit Report
| Plaub Hlis Ntuj 3 , 2025
Npaj teb nrog CAP
Tsib Hlis 2, 2025
DHCS Teb rau CAP
Tsib Hlis 5, 2025
Npaj teb nrog CAP
Lub Rau Hli 2, 2025
DHCS Teb rau CAP
Lub Xya hli ntuj 2, 2025
Npaj teb nrog CAP
Lub Yim Hli 1, 2025
DHCS Teb rau CAP
|
2023
2022
Access Dental Plan
|
2/6/2023 – 2/17/2023
|
2022 Audit Report
| Plaub Hlis Ntuj 12 , 2024
Npaj teb nrog CAP
Tsib Hlis 10, 2024
DHCS Teb rau CAP
Lub Rau Hli 7, 2024
Npaj teb nrog CAP
Lub Xya Hli 3, 2024
DHCS Teb rau CAP
|
Health Net ntawm California, Inc. |
3/21/2022 – 4/1/2022 |
2022 Audit Report
| Plaub Hlis Ntuj 12 , 2024
Npaj teb nrog CAP
Tsib Hlis 10, 2024
DHCS Teb rau CAP
Lub Rau Hli 10, 2024
Npaj teb nrog CAP
Lub Xya Hli 2, 2024
DHCS Teb rau CAP
Lub Xya hli ntuj 31, 2024
Npaj teb nrog CAP
Lub Yim Hli 27, 2024
DHCS Teb rau CAP |
Liberty Dental Plan of California, Inc. |
8/8/2022 – 8/19/2022 |
2022 Audit Report
| Lub Peb Hlis 3, 2023:
Npaj teb nrog CAP Kaum Ob Hlis Ntuj 22, 2023:
DHCS Teb rau CAP
|
2021
2020
Thov nco ntsoov: Lub Department yog i n tus txheej txheem ntawm kev hloov kho tag nrho cov lus teb Plan.
DMC Plan Deficiencies
2025
2024
2023
Access Dental Plan
|
Lub Rau Hli 30, 2023
|
Hu rau Center Report
| Lub Xya hli ntuj 24, 2023:
Npaj teb nrog CAP
Lub Yim Hli 18, 2023:
DHCS Teb rau CAP
Lub yim hli ntuj 25, 2023:
Npaj teb nrog CAP
Cuaj hlis 25, 2023:
DHCS Teb rau CAP
Lub kaum hli ntuj 4, 2023:
Npaj teb nrog CAP
Kaum Hli Ntuj 26, 2023:
DHCS Teb rau CAP
|
Access Dental Plan
|
Lub Rau Hli 30, 2023
|
| Lub Xya hli ntuj 27, 2023:
Npaj teb nrog CAP
Lub Yim Hli 18, 2023:
DHCS Teb rau CAP
Cuaj hlis 1, 2023:
Npaj teb nrog CAP
Cuaj hlis 29, 2023:
DHCS Teb rau CAP
Lub kaum hli ntuj 13, 2023:
Npaj teb nrog CAP
Kaum Ib Hlis 14, 2023:
DHCS Teb rau CAP
|
Cov Kev Kho Hniav Menyuam Yaus Txaus Siab ntawm Kev Tshawb Fawb Tshaj Tawm
2022
2021
2020
2019
2018
2017
Thov nco ntsoov: Lub Tsev Haujlwm tab tom hloov kho tag nrho cov lus teb rau Txoj Haujlwm.
Daim ntawv ntsuam xyuas
Network Certification
Txhawm rau saib Daim Ntawv Pov Thawj Network Txhua Xyoo, thov mus saib hauv Network Adequacy webpage.
Kev Ntsuam Xyuas Sab Nraud Zoo
Yog xav pom 2020-2021 Medi-Cal Dental Managed Care External Review Technical Report, thov mus saib hauv Medi-Cal Managed Care Quality Improvement Reports webpage.
Stakeholder Engagement
Waiver Resources
