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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 4 Texas Health Steps (THSteps) Dental : 4.2 Services, Benefits, Limitations, and Prior Authorization : 4.2.5 ICF-IID Dental Services : Children in Foster Care
Clients in foster care receive services from Superior HealthPlan’s dental contractor. Providers may contact DentaQuest at 1-888-308-9345 for more information.
Paper claims and requests for prior authorization must be mailed to:
12121 North Corporate Parkway
Mequon, WI 53092
Fax: (262) 241-7150 or 1-888-313-2883

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.