Information and Updates for Dental Care Providers
Important Reminders and Updates
Click here to read our September 2014 update to community dental care providers. The update provides information on our services, public health dental clinics, and recent events.
Healthy Smiles Ontario
For information about the Healthy Smiles Ontario Program, visit the ‘health care professional channel’ of the Ministry of Health and Long-Term Care’s website at http://www.health.gov.on.ca/en/pro/programs/dental/ – no registration required and Accerta’s – Provider Portal at http://accerta.ca/en/provider/accertaworx – registration is required on AccertaWorx landing page.
WHAT DO I NEED TO KNOW?
Current publicly-funded oral health benefits and/or programs (i.e., dental benefits for children under Ontario Works, the Ontario Disability Support Program, the Assistance for Children with Severe Disabilities Program, the Children In Need of Treatment Program, the Healthy Smiles Ontario Program, and preventive services within the Ontario Public Health Standards, 2008) are being integrated into one program – Healthy Smiles Ontario – as of January 1, 2016.
The new program will serve children and/or youth who meet specific eligibility requirements including financial, Ontario residency and age.
The new program will include preventive, core (routine and restorative) and emergency/essential services streams.
There will be a new HSO dental card for all clients. Clients who are enrolled in current programs are being transitioned to the new program and will receive a new card prior to January 1, 2016.
All clients will have a standard benefit year – August 1st to July 31st, except clients in the emergency and essential services stream who will be eligible for 12 months from their date of enrollment. All cards will display an expiry date clearly.
Electronic claims submission will be implemented as of January 1, 2016 with Accerta as the new program administrator.
Some pre-authorizations will still have to be submitted by paper for a short time. The Ministry is working with Accerta to also implement electronic processes for submission of pre-authorizations and other documentation. This is expected to be in place as soon as possible in 2016.
Treatment plans for currently enrolled children will continue. Providers are asked to keep treating currently enrolled children.
You are asked to keep treating HSO, CINOT and Social Assistance clients. They will be transitioned to the new program and will receive a new card.
A new service schedule is under development and will be available in the coming weeks.
As of January 1, 2016 claims must be submitted to Accerta. Claims may be mailed, sent via secure fax, or submitted electronically (EDI) to Accerta:
For EDI submissions, the Primary Policy/Plan Number is HSO. 4
Accerta’s carrier code is 311140 and can be added under the Instream network.
AccertaClaim Servicorp Inc.
Healthy Smiles Ontario Contact Centre
Station P, P.O. Box 2286
Toronto, ON, M5S 3J8
Secure Fax: 416-354-2354 or toll-free at 1-877-258-3392
For more information please visit: http://www.health.gov.on.ca/en/pro/programs/dental/default.aspx
For more information (FRENCH) please visit: http://www.health.gov.on.ca/fr/pro/programs/dental/
Monitoring of Community Water Fluoride Levels
The Public Health is responsible for reviewing monthly water quality reports for all municipal drinking water supplies, where fluoride is added. This ensures fluoride concentrations are maintained at a desirable level. If necessary, action is taken to address deviations.
Last modified on Feb 12, 2016