Medicaid requirements for RIte Smiles dental professionals

Q4 Word of Mouth newsletter 2022

Federal laws enforced by the Centers for Medicare & Medicaid Services (CMS), including the Affordable Care Act and the 21st Century Cures Act 114 P.L. 255, require all states to screen and enroll all Medicaid providers in Medicaid fee-for-service (FFS) and managed care organizations (MCOs). Providers who don’t comply with this requirement risk being removed from the Rhode Island (RI) Medicaid managed care network.

What you need to do

All contracted UnitedHealthcare RIte Smiles dental professionals who file claims with RI Medicaid require a RI Medicaid ID number. You should receive one after the state screens and enrolls you in Medicaid. If you don’t have a RI Medicaid ID number, please promptly submit for one.

You can access the application for enrollment and screening directly from the RI Medicaid Health Care Portal. Select MCO (Managed Care Organization) Provider in the “Type of Provider Enrollment” section and complete the required information.

For ease of completing the application process it is best to have the below information available for reference:

• National Provider Identifier number
• Address information including postal code
• Taxonomy codes
• Tax ID – either your employee identification number or Social Security number
• License number

If you choose to enroll in FFS, also attach your completed W-9 form. You must sign and date the form within the same month you complete the enrollment application.