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June 8 2026 Dental Services Post Payment Reviews
June 8, 2026: Attention Dental Providers: The Michigan Department of Health and Human Services (MDHHS) is in the process of a post payment review of claims billed for dental services that may have exceeded the programs frequency limitations based on history of paid claims. Claims that are identified during this process are subject to claim recoupment. Refer to MSA 24-14 for Dental Frequency Verification (DFV) guidelines.
Claim(s) voided and recouped can be verified with the claim note: “Dental Frequency Verification Recoupments”. If the claim(s) is voided and determined by the provider that the recoupment was done in error a new claim(s) will need to be submitted. The new claim(s) must include all medical documentation supporting the procedure completed, including the Dental Frequency Verification, at which point the claim(s) will be manually reviewed for processing.
As a reminder, any claims recouped due to limit exceeded cannot be billed to the beneficiary as MDHHS policy guidelines were not followed. For policy information refer to the Medicaid Provider Manual, General Information for Providers, Chapter 10 Billing the Beneficiary.