KMAP BULLETIN: Updated ADA Dental Claim Form Guidance

Date: 03/18/24

KMAP GENERAL BULLETIN 24024 (PDF)

Effective with dates of service and retroactive to January 1, 2024, dental providers under the Locum Tenens Arrangements will note in the box Field 53a on the American Dental Association (ADA) Form and will no longer need to note in Field 35. Providers must transition to Field 53a and discontinue using Field 35 by  June 1, 2024.

The current Locum Tenens policy provisions and provider responsibilities will remain the same.

Note: The effective date of the policy is January 1, 2024. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the Kansas Medical Assistance Program (KMAP) bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.

For the changes resulting from this provider bulletin, view the updated KMAP Provider Portal Dental Billing Packet and the Dental Fee-for-Service Provider Manual for more details on instructions regarding further instructions regarding Locum Tenens Arrangements.