UPDATE: Beginning on July 1, 2017, you will be required to use your dental plan’s appeal procedures before you will be able to file for a state fair hearing. Federal law has changed and now requires this new process.
You are not losing your right to a state fair hearing. If you need more information please call Member Services and request the notice “Your Rights Under Dental Managed Care” telling you what these new rights will be.
Thank you for visiting the Access Dental Plan webpage dedicated to Sacramento Geographic Managed Care (GMC) and Los Angeles Prepaid Health Plan (PHP) members! Our customer service representatives are here to answer questions you may have about Access Dental Plan, help you find a dentist, or answer any other questions you may have about your dental plan. You may also visit California’s Department of Health Care Services’ website for more on the California Medicaid Program at www.dhcs.ca.gov.
Member Services Contact
IMPORTANT: If you are having issues with setting a dental appointment and/or are not satisfied with the appointment options given by your dentist please call Member Services to assist you!
Once you choose Access Dental Plan for your dental needs, you will receive a dental ID card. If you have misplaced either of these and would like to request a copy please contact Member Services. The Handbook includes lots of great information including, covered benefits, who to call for assistance, your rights and responsibilities, provider information, and additional forms.
You also have access to easy-to-understand videos on flossing, brushing, toothpaste, whitening and more through this website. Please go to www.premierlife.com/educationalvideos to watch!
If you do not have transportation to a dental appointment, please contact Member Services to determine if you qualify for plan sponsored assistance.
The Plan offers language assistance services. There is no charge for the services. Call Member Services to request language services (TDD/TYY) for the hearing impaired at 800.735.2929).Please inform your provider if you have a preferred language other than English. Your provider will work with us to provide the language services you need.
- Interpreter services: You can speak to Member Services in your preferred language.
- Find a provider who speaks your language: We can help you find a provider who speaks your language. If a provider cannot be located, you can request an interpreter for your appointment.
- Assistance filing a grievance: The Grievances and Appeals Section describes the process for filing a complaint or grievance. You can ask for language assistance if you need help with the process.
Translated materials: Standard documents (such as member assignment notifications or grievance forms) are available in certain languages under the GMC and PHP programs. You can also request translation of a non-standard document (such as a flyer you may receive from the plan). The Plan shall provide the translation within 21 days of the request.
Filing a Grievance or Complaint
During your dental treatment, you may encounter a decision or action made by the Plan or your dentist with which you do not agree. This could include:
- You were unable to find a dentist.
- You were unable to make a routine appointment within 4 weeks.
- You were unable to make an emergency appointment within 24 hours.
- You received poor quality of care.
- You were treated unfairly by a dentist or staff member.
- You were discriminated against.
If your question is care-related, speak first with your dentist about concerns you may have. If your concern is related to your coverage or a service issue, please contact Access Dental Plan. If after you have made your initial inquiries, you are still unhappy, you may file a Grievance by calling or writing to Access Dental Plan.
Call our toll free Member Services line; for GMC 877.821.3234 or PHP 888.414.4110, or write to us using our Grievance Form.
Mail this Grievance form to:
Access Dental Plan
P.O. Box 255039
Sacramento, CA 95865–5039
If you are not happy with the results of your grievance, you can ask for a State Fair Hearing. Call the State Department of Social Services’ Public Inquiry and Response Unit toll free at 800.952.5253.
LA Outreach Department – Enrollment
If you live in Los Angeles and are receiving services in the Denti-Cal Fee-for-Service program and would like to enroll into Access Dental Plan please contact our enrollment specialist at 800.240.6861.