Medicare Advantage & Medicaid Plans
Our Goal - The effects of having a robust & comprehensive dental benefits manager.
- Increase member access to preventive and comprehensive dental services
- Increase and retain membership
- Increase member satisfaction
- Improve the management of dental benefit expenditures
- Reduce your administrative costs
- Improve the servicing and oversight
- FCL Dental will provide a quality partnership and align with our client’s strategic direction and culture
FCL Health Plan Contractual Relationships
- Full Risk
- Administrative Services Only (ASO)
- Delegation (Full or partial)
- Compliance (CMS, URAC, & NCQA)
- Network Development & Provider Relations
- Credentialing
- Member Services
- Claims
- Information Technology
FCL Dental Provider Network
- Nationwide Coverage
- Over 20,000 dental office locations
- Access and availability 1 General Dentist every 30 miles (CMS standard 1/75)
- Efficient credentialing process
- Seamless network transition with concise disruption reporting
- We will meet your needs!
FCL Compliance Commitment
- We are required to implement an effective compliance program that meets the regulatory requirements.
- We are committed to applying the principles outlined in these guidelines to all relevant decisions, situations, communications and developments.
- It is essential for our mission to deliver health care services to our customers with accountability for our fiscal and ethical performance.
- Our staff is trained annually on ethical, fraud, waste, and abuse regulatory requirements
- Trust, truth and ethical standards are part of what we do, every time and every day
Post Contracting Implementation
- Contractual performance guarantees
- Member-focused project management implementation team
- Seamless transition
- Minimize network disruption (if any)
- Compliance Partnership (CMS, URAC, & NCQA)
- All hands on deck!
- Network Development & Provider Relations
- Credentialing
- Member/Customer Services
- Claims
- Information Technology
FCL Reporting & Beyond
- We will work in conjunction with the plan to provide all required reporting, timely and accurately.
- Credentialing
- Access
- Quality Improvement
- Risk Management
- Measurement Requirements
- Financial
- Medicare Specific Reports
FCL Network Assist
- For plans that want to insource the management of dental benefits, FCL will work with the plan:
- Transition either comprehensive or incrementally
- Develop project management plan and strategic alignment
- Train and transition:
- Claims
- Customer Service
- Credentialing
- Reporting
- Transition network dental providers to your contracting template
Kerry M. Marcus, MBA
[email protected] 101 Parklane Blvd., Suite 301
Sugar Land, TX 77478
Cell - 504-914-8284
Office - 1-877-493-6282 or 281-313-7150
Fax – 281-966-1751