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Dental Flowchart
Adaptive Aid Flowchart
Dental Flowchart
Minor Home Modification Flowchart
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Page-1
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STEP 1 The Service Planning Team (SPT) completes Form 3660 & ...
STEP 1
The Service Planning Team
(
SPT
)
completes Form
3660
&
secures
treatment plan
.
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STEP 2 DSSW will... A. Verify funds for specifications and tr...
STEP 2
DSSW will
...
A
.
Verify funds for specifications and treatment
plan and forward to the Case Manager
.
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STEP 4 – Procurement Process DSA initiates delivery of dental...
STEP 4 – Procurement Process
·
DSA initiates delivery of dental
treatment
.
·
DSA has
14
calendar days from the
authorization to initiate service
.
DSA
will contact client and send
2067
within
14
days if there will be a delay
in service
.
·
DSA will obtain invoice from dentist
when the work is completed
.
CONTINUE to STEP
5
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STEP 3 – Cost of Item Form 2067, treatment plan sent to the C...
STEP 3 – Cost of Item
·
Form
2067
,
treatment plan sent to the CMA
requesting funds
.
·
IPC received from the Case Manager and
signed by the Program Director
.
·
Notice
:
Effective date will be at least
30
days
out from the last signature date on IPC
.
·
PD checks to see that funds are added to the
clients MESAV
.
·
Purchase Order is initiated and approved in
DSSW system
.
CONTINUE to STEP
4
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Sheet.12
Dental Flowchart DSSW is happy to have the opportunity to ass...
Dental Flowchart
DSSW is happy to have the opportunity to assist you with securing your dental services
.
Please recognize that this process is not fast
–
there are CLASS rules that must be followed
.
Three months to completion is the norm
.
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STEP 5 – Documentation of Completion Form 8605, should be com...
STEP 5 – Documentation of
Completion
·
Form
8605
,
should be completed by
DSSW staff within
10
workdays of
the delivery
.
·
Completed Form
8605
Faxed to Case
Manager within
7
DADS workdays
.
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CONGRATULATIONS! Your dental work is complete.
CONGRATULATIONS!
Your dental work is complete
.
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