Dental
Molina Dental Services partners with SKYGEN, USA to administer MississippiCAN and CHIP Dental benefits for Molina Healthcare of Mississippi.
Dental Claims
Please note that when submitting a dental claim to SKYGEN, via the provider portal, clearing house or ADA claim form, the member ID must include the preceding five zeros (00000) as part of the Member ID to receive payment.
Claim filing information
- SKYGEN Provider Portal – to gain access contact SKYGEN at (855) 434-9239
- Clearinghouse Submission – SKYGEN Payor ID -SKYGN
- On a claim form to: Molina Dental Services Claims | P.O. Box 2136 | Milwaukee, WI 53201
Dental Prior Authorizations
Prior Authorization of Dental Treatment in an Outpatient Hospital or Ambulatory Surgical Center setting must be submitted as follows:
- Providers should submit request using ADA code D9999 with the required Molina Mississippi Hospital Worksheet and all services that are requested to be performed on the ADA Claim form.
- Prior Authorization should be submitted on the SKYGEN Provider Portal. To gain access contact 855-434-9239.
- Mississippi Hospital Worksheet - located on the SKYGEN Provider Portal
- If approved, SKYGEN is to submit the Molina Mississippi Hospital Worksheet to Molina including the SKYGEN dental approval to review and determine the approval of the Outpatient Hospital or Ambulatory Surgical Center facility.
- Provider will notify facility of approval. Facility will request prior authorization from Molina.
- A copy of the determination will be sent via mail to the provider and member.
- If denied, the provider and member have options listed for the appeals process on the notification received.
*Please note that all provider fax, and email information must be kept up to date*
If you have any questions, please contact Molina Dental Services via email at MDVSProviderServices@MolinaHealthCare.Com