Complaints, Grievances & Appeals

Complaints

A complaint is any oral or written expression of dissatisfaction by an enrollee submitted to the Dental Plan or to a state agency and resolved by close of business the following business day.

Submit a complaint to your Dental Plan

DENTAQUEST

Call: 1-888-468-5509
TTY 1-800-466-7566

LIBERTY

Call: 1-833-276-0850
TTY 1-877-855-8039

MCNA Dental

Call: 1-855-699-6262
TTY 1-800-955-8771

Submit a complaint to the Florida Agency for Health Care Administration

You can file a complaint using the Florida Medicaid Complaint form or call the Medicaid Helpline at 1-877-254-1055 (TDD 1-866-467-4970). 

Once you file your complaint, you will get a tracking number to check the status of your complaint. If you have already submitted a complaint, you can check the status of complaint.

The complaints filed with the State agency are prioritized based on the urgency of the reported issue and not the order received. 

For more information about the steps of filing a complaint with the Agency for Health Care Administration, please visit their webpage.

Grievances

A grievance is an expression of dissatisfaction (other than an organization’s determination) with any aspect of a Medicaid health plan’s operations, activities, or behavior or its providers, regardless of whether remedial action is requested.

Types of Medicaid Grievances

Lack of Quality Care

A patient is under obvious stress while the provider is performing a cleaning. The provider disregards the patients’ complaints and continues to perform the procedure.

HIPPA Violation

A dental hygienist is overheard sharing private patient information with other staff while making inappropriate comments.)

Issues Requesting Care

Problem getting an appointment or having to wait a long-time for an appointment.

Refusal of Services

A provider denies an eligible Medicaid patient a service that they are entitled to under their Medicaid plan.

Cultural/ Linguistic Discrimination

A Spanish speaking patient arrives to their appointment and is consistently being disregarded due to the language barrier. This patient has trouble filling out the insurance form and the receptionist has ignored the patient’s advance for assistance.

Failure to Inform

A provider fails to report an unusual finding on an x-ray. Later, the patient finds out that the unusual sighting was bone loss in the jaw that was unreported.

How to Submit a Grievance

Grievances can be filed at any time. Grievances are reviewed within 30 days.

For more information about submitting a grievance, please consult your member handbook.

You can submit your grievance by phone, fax or mail.

Phone: 1-888-468-5509

TTY 1-800-466-7566

Fax: 1-262-834-3452

Mail to:

DentaQuest

Attn: Complain and Grievances Department 

P.O. Box 2906 Milwaukee

WI 53201-2906

You can submit your grievance by fax, phone, email, mail or electronically by using an online form. 

Phone: 1-833-276-0850

TTY 1-877-855-8039

Mail to:

LIBERTY Dental Plan Grievance Departments

P.O. Box 15149

Tampa, FL 33684

The online form and more ways to submit can be found on LIBERTY website.

You can submit your grievance by phone or mail. 

Phone: 1-855-699-6262

TTY 1-800-955-8771

Mail to:

MCNA Dental

Attn: Grievances and Appeals

P.O. Box 740370

Atlanta, GA 30374-0370

Appeals

An appeal is a formal request from an enrollee to seek a review of an adverse benefit determination made by the Dental Plan. If you do not agree by the decision made by your Dental Plan about your services, you can ask for an appeal. 

Appeals must be filed within 60 days of the plan’s decision about your services. You will receive a letter within 5 business days that tells you that your appeal has been received. Appeals are reviewed within 30 days. If you think waiting for 30 days will put your health in danger, you can ask for an Expedited or “Fast” Appeal. For fast appeals, the plan will provide you with an answer within 48 hours. 

For more information about asking for an appeal, please consult your member handbook.

You can ask for an appeal by phone, fax or mail. 

Phone: 1-888-468-5509

TTY 1-800-466-7566

Fax: 1-262-834-3452

Mail to

DentaQuest – Provider Appeals

PO Box 2906 

Milwaukee, WI 53201-2906

You can ask for an appeal by fax, phone, email, mail or electronically by using an online form. 

Phone: 1-833-276-0850

TTY 1-877-855-8039

Mail to:

LIBERTY Dental Plan Appeals Departments

P.O. Box 15149

Tampa, FL 33684

The online form and ways to submit can be found on LIBERTY website.

You can ask for an appeal by phone or mail. 

Phone: 1-855-699-6262

TTY 1-800-955-8771

Mail to:

MCNA Dental

Attn: Grievances and Appeals

P.O. Box 740370

Atlanta, GA 30374-0370

Medicaid Fair Hearing

If you don’t’ agree with the appeal decision, you can ask for a Medicaid Fair Hearing. However, you must finish the appeal process before asking for a Medicaid Fair Hearing. For more information about asking for a Medicaid Fair Hearing, please consult your handbook, or visit the Agency of Health Care Administration page.

Information about submitting complaints, grievances and appeals was retrieved from the Medicaid member handbooks: DentaQuest, LIBERTY, and MCNA Dental on June 23rd, 2023.

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