Medicaid Information for Dental Professionals
Apply to Enroll in Medicaid
As a dental professional in Rhode Island, you can easily apply to enroll in Medicaid online at riproviderportal.org. The requested documentation is very similar to what private insurance companies require.
Get Help Enrolling
A dedicated team of experts and resources are available to help your practice enroll in Medicaid.
The online application is easy to use and there is an automated assistant, as well as a user guide, to help you each step along the way.
If you need additional help with the application process, contact an enrollment specialist at (401) 784-8100 or email rienrollment@gainwelltechnologies.com.
Resources for New and Existing Medicaid Providers
Which services are covered by Medicaid? How do I bill for them? Who can I contact if I have questions? A wealth of training and resources are available to educate you and your staff about Medicaid.
As a dental provider in Rhode Island, your dedicated Medicaid representative is Andrea Rohrer. Andrea can answer your questions about the enrollment process, billing, or payment. Reach out to her to learn more or schedule a meeting.
(469) 897-4389
- Provider Training and Education Web Page
- Self-paced trainings
- Sign up for a virtual training
- Dental Manual
- Policies, requirements, and eligibility
- Claims billing
- Prior authorization information
- Definitions of commonly used terminology
- Covered services
- In Plan Oral Health Benefits
- Dental codes that the Medical managed care plans cover
- Billing and Claims Web Page
- Billing Tips for Dental Providers Slide Deck
- Both the web page and slide deck explain the basic standards required for billing and claims processing
- Medicaid Claims Payment Schedule
- Dental Rates
- Dental codes with recently updated rates
- Compare Medicaid and commercial rates
- Medicaid Dental Practice Management and Quality Improvement: Watch the Information Session Recordings
Why Enroll in Medicaid?
About 1/3 of Rhode Islanders have oral health insurance through Medicaid. That’s more than 300,000 people, including:
- 7,000 in Bristol County
- 38,000 in Kent County
- 240,000 in Providence County
- 21,000 in Washington County
- 15,000 in Newport County
By addressing the oral health needs of adults and families from marginalized and disadvantaged communities, you can help improve health equity in Rhode Island. According to national data, improved access to dental care may even help lower rates of preventable emergency department visits and opioid misuse in the Ocean State.
RI Medicaid dental reimbursement rates are higher than ever. Medicaid reimbursement rates for many oral health services have increased by more than 100%. To view some examples of current rates, visit bit.ly/RI-Medicaid-Dental-Rates.
The current oral health system is experiencing significant hurdles; therefore, it is time to look towards innovative care models to address the growing gaps in care. That’s why EOHHS and the RI Dental Association held Virtual Medicaid Town Halls to share information about new resources available to dental professionals.
Watch our three-part series and learn about new resources for dental professionals and projects intended to reach adults disproportionately impacted by limited access to oral care. A summary of speakers and topics discussed during each session can be found here.
All resources and initiatives shared during the Medicaid Townhalls are also shared in the EOHHS Oral Health Transformation Portfolio including Workforce Development, Utilizing Public Health Dental Hygienists (PHDHs) and Community Health Workers (CHWs), Frequently Asked Questions About Medicaid, Strategies for Practice Performance, and more. EOHHS Oral Health Transformation Overview also provides a comprehensive and strategic overview to of RI's efforts to address disparities in oral health within the state.