Common use of Dental Provider for Enrollees With Special Needs Clause in Contracts

Dental Provider for Enrollees With Special Needs. (A) The Contractor shall have policies and procedures to inform caregivers, and when appropriate, Enrollees With Special Health Care Needs, about Dental Providers who have training in caring for such Enrollees. (B) The Contractor shall contract with Dental Providers with skills and experience to meet the needs of Enrollees with Special Health Care Needs. (C) For Enrollees determined to need a course of treatment or regular care monitoring, the Contractor shall have a mechanism in place to allow Enrollees to directly access a specialist (for example, through standing referral or an approved number of visits) as appropriate for the Enrollee’s condition and identified needs. The Contractor shall allow an appropriate specialist to be the Enrollee’s Dental Provider but only if the specialist has the skills to monitor the Enrollee’s preventative and primary care services.