Although the SDF-specific findings from Medicaid audits have been resolved, it is time for audited dentists to address the additional findings.
The following message is from Medicaid: Any overpayments identified for reasons other than (or in addition to) a missing SFD‑specific consent form still need to be handled through the normal audit and appeal process used by the MCO that issued the payment.
While a missing SFD‑specific consent form by itself is not enough to classify a claim as an overpayment, any other issues—such as missing treatment plans, missing diagnoses, or a lack of documentation showing medical necessity—can still make a payment an overpayment and subject to recovery.
In other words, please make payment at this time while simultaneously working through any appeals process with the MCO.
