 |  | Login to MyCompBenefits.com | | | | Florida Healthy Kids Program (Effective 2003 - 2004)
Recently in its 2003-2004 budget, the Florida Legislature approved significantreductions in the funding for the dental portion of the Florida Healthy Kidsprogram. Highlights of these changes are: - A $750.00 plan year benefit maximum effective 7/1/03 - 6/30/04.
- The plan year maximum applies to all covered services, including specialty care.
Orthodontic services provided at a 25 percent discount are excluded from the benefit maximum.
- The policy year maximum is based on the date of service and not when the claim was paid. Therefore, if a procedure is completed on 6/30/03 and paid on 7/7/03, it will not count against the policy year maximum.
- You may submit a claim for predetermination to the Healthy Kids claims address; however, we encourage you to verify benefits as close to the date of service as possible by calling Customer Care at 1-877-531-3026. You will receive verification of remaining benefits and eligibility verification via fax.
- Failure on your part to determine benefit prior to treatment increases the chance that your claim will be denied in part or in full if the member's benefit maximum has already been met.
- Members will receive an Explanation of Benefits upon the processing of your claims; however, it is recommended that you continue to contact our Customer Care department as close to the date of treatment as possible to determine the available remaining benefit as well as to verify eligibility.
The Healthy Kids Program has enabled thousands of children throughout the state to receive much needed dental care. While we certainly recognize the new challenges that these plan changes represent to you and your staff, we are pleased that the program will still be offered.
If you have any questions or concerns, we ask that you contact your local ProfessionalRelations Representative or Rosa Palma at (877) 531-3026, ext. 2252.
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