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LIBERTY Dental Plan Corporation received full Dental Plan accreditation by URAC as of 7/1/2019

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2017
HITRUST Certified

LIBERTY received HITRUST CSF v8.1 certified status for its Health Solutions Plus core application and supporting systems as of 11/20/17
 
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2020
HEDIS NCQA Certified

 LIBERTY Dental Plan was presented with a
2020 NCQA-Certified HEDIS® Compliance Audit™
by AttestHealth Care Advisors, LLC, an NCQA certified audit group.
 
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File a Grievance or Appeal Link Icon

Language Assistance Information | 語言協助信息 | Información sobre Asistencia en su Idioma

LIBERTY Dental Plan of California Notice of Language Assistance Services PDF Icon
California Exchange Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Florida Notice of Language Assistance Services PDF Icon
Florida Exchange Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Missouri Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Nevada Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of New Jersey Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Oklahoma Notice of Language Assistance Services PDF Icon
 

For additional information, please call a LIBERTY Dental Representative
at 1-888-703-6999.


LIBERTY Dental Forms

(All forms available for download in PDF format)
Member Satisfaction Survey PDF Icon
ADA Claim Form PDF Icon
HIPAA Authorization Medical\Dental Release FormPDF Icon   -  Spanish Version PDF Icon
Clinical Criteria and Practice Parameters PDF Icon
HIPAA Privacy Notice PDF Icon

The materials provided to you are guidelines used by this Plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract.

Member Handbooks & Evidence of Coverage (EOC)

California

LDP Individual EOC Booklet PDF Icon Spanish PDF Icon
LIBERTY Dental Plan CA Group EOC Booklet PDF Icon Spanish PDF Icon

Nevada

NV-100 through NV-1000 NV Commercial DHMO - EPO PDF Icon
Patriot NV-100 through Patriot NV-900NV Commercial Patriot Plan PDF Icon
Elite PPO, Signature PPONV Commercial PPO Plans PDF Icon
NV-500 POSNV Commercial Point of Sales Plans PDF Icon
LIBERTY Dental Plan NV Member Handbook PDF Icon Spanish PDF Icon

Florida

Individual FL Individual Plans PDF Icon
Group FL Group Plans PDF Icon
LIBERTY Dental Plan FL Member Handbook PDF Icon Spanish PDF Icon

Missouri

Missouri – EOC Booklet PDF Icon

Medi-Cal


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Members

File a Grievance or Appeal Link Icon

Language Assistance Information | 語言協助信息 | Información sobre Asistencia en su Idioma

LIBERTY Dental Plan of California Notice of Language Assistance Services PDF Icon
California Exchange Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Florida Notice of Language Assistance Services PDF Icon
Florida Exchange Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Missouri Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Nevada Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of New Jersey Notice of Language Assistance Services PDF Icon
LIBERTY Dental Plan of Oklahoma Notice of Language Assistance Services PDF Icon
 

For additional information, please call a LIBERTY Dental Representative
at 1-888-703-6999.


LIBERTY Dental Forms

(All forms available for download in PDF format)
Member Satisfaction Survey PDF Icon
ADA Claim Form PDF Icon
HIPAA Authorization Medical\Dental Release FormPDF Icon   -  Spanish Version PDF Icon
Clinical Criteria and Practice Parameters PDF Icon
HIPAA Privacy Notice PDF Icon

The materials provided to you are guidelines used by this Plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract.

Member Handbooks & Evidence of Coverage (EOC)

California

LDP Individual EOC Booklet PDF Icon Spanish PDF Icon
LIBERTY Dental Plan CA Group EOC Booklet PDF Icon Spanish PDF Icon

Nevada

NV-100 through NV-1000 NV Commercial DHMO - EPO PDF Icon
Patriot NV-100 through Patriot NV-900NV Commercial Patriot Plan PDF Icon
Elite PPO, Signature PPONV Commercial PPO Plans PDF Icon
NV-500 POSNV Commercial Point of Sales Plans PDF Icon
LIBERTY Dental Plan NV Member Handbook PDF Icon Spanish PDF Icon

Florida

Individual FL Individual Plans PDF Icon
Group FL Group Plans PDF Icon
LIBERTY Dental Plan FL Member Handbook PDF Icon Spanish PDF Icon

Missouri

Missouri – EOC Booklet PDF Icon

Medi-Cal