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| Reporting and solving grievances
California Children Services (CCS) Program: A public health program which provides
specialized diagnostic, treatment, and therapy services to eligible children under the age of 21
years who have CCS eligible conditions as defined state regulations.
Caries: Another term for tooth decay or cavities.
Child Health and Disability Prevention (CHDP) Program Services: Preventive health care
services for beneficiaries under 21 years of age provided under the state law and regulations.
Clinical Screening: An examination by a dentist to provide an opinion about the
appropriateness of treatment proposed or provided by a different DMC dentist. The DMC may
require a clinical screening under certain circumstances.
Complaint: A verbal or written expression of dissatisfaction, including any dispute, request for
reconsideration, or appeal made by you, or a dentist on your behalf. A complaint can also be
made by your representative.
Copayment: A small portion of the dentist’s fee that is paid by the beneficiary.
Covered Services: The set of dental procedures that are benefits of the LIBERTY. The
LIBERTY will only pay for medically necessary services provided by a LIBERTY dentist that
are benefits of the Medi-Cal dental program.
Dental Specialist: A dentist providing specialty care such as endodontics, oral surgery,
pediatric dentistry, periodontics, and orthodontics (braces).
Denti-Cal Dentist: A dentist who has been approved to provide covered services to Medi-Cal
beneficiaries.
Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT): A federal
program that provides health care for children through periodic screenings, diagnostic and
treatment services. Dental care is included in the EPSDT program.
Eligibility: Refers to meeting the requirements to receive Medi-Cal benefits.
Emergency Care: A dental examination and/or evaluation by a LIBERTY dentist or dental
specialist to determine if an emergency dental condition exists, and to provide care to treat
any emergency symptoms within the capability of the facility within professionally recognized
standards of care.
Emergency Dental Condition: A dental condition that the absence of immediate attention
could reasonably be expected to result in placing the individual’s health in jeopardy, causing
severe pain or impairing function.
Endodontist: A dental specialist who limits his or her practice to treating disease and injuries
of the pulp and root of the tooth.
Exclusion: Refers to any dental procedure or service not available under the Medi-Cal dental
program.
Grievance: See Complaint.
Identification: Refers to something that proves who a person is, such as a driver’s license.
Limitations: Refers to the number of services allowed, type of service allowed, and/or the
most affordable dentally appropriate service.
Medically Necessary: Covered services which are necessary and appropriate for the
Call Member Services at 888-703-6999 (TTY 800-735-2929). We’re here
Monday through Friday 8:00 a.m. to 5:00 p.m. The call is free.
Visit us online at www.libertydentalplan.com.
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