The West Virginia Oral Health Coalition is pleased to announce that we are a recipient of a $25,000 grant focusing on improving children’s oral health. The grant is funded by Oral Health America’s “Smiles Across America”, a childhood sealant program. Funds will support school-based dental programs, private dentists, and programs working in collaboration to provide dental sealants to the children of West Virginia.
The funding will go to offset the costs of providing preventive care to those uninsured or underinsured children throughout the state. Eligible Children include: (1) those who do not have private dental insurance (2) those who have private dental insurance but it doesn’t cover sealants and (3) those who are not eligible to receive Medicaid/CHIP assistance.
The grant award in its entirety will be used to cover the services highlighted below. Reimbursement for services will only be available until funding is depleted. Once the grant funds are exhausted, participating providers will be notified immediately.
Providers must agree to accept the reduced rate for those covered services and must work with the child’s family to assure necessary additional treatment is provided. Provider must also agree to serve as the dental home or work to establish a dental home for the child.
Providers may only submit reimbursement for those services NOT covered by another program or insurance provider. Providers will be responsible for verifying that the child is not eligible for other coverage such as CHIP/Medicaid. Providers must also bill other insurance or programs for those children with pre-existing coverage. This program is not intended to be a budget supplement.
Dental Sealants ADA Code D1351 per Tooth $30 (permanent molars only, covered one time a year per student per tooth)
The following codes can only be billed in conjunction with sealant placement
Child Prophylaxis ADA Code D112 $40
2 Bitewing x-rays ADA Code D0272 $20
Fluoride Varnish Treatment ADA Code D1206 $20
In submitting for reimbursement the provider is agreeing to the terms listed above. Checks will be issued on a monthly basis’s until funds are depleted and providers are encouraged to submit claims in a timely fashion. To receive reimbursement, a copy of the attached invoice along with the ADA billing form will need to be submitted to:
West Virginia Oral Health Coalition
Barb Thaxton, Coordinator
PO Box 11133
Charleston, WV 25339