Section R20-6-1809. Contract Requirements

A.      An Organization shall have a written contract with each pro- vider that documents the requirements for providing services under the prepaid dental plan and the terms of the agreements between the parties. The Organization shall ensure that the provider complies with all contract requirements.

B.       In addition to the requirements in subsection (A), an Organiza- tion shall ensure that its contract with a provider includes the following provisions:

1.        That the Organization has authority to review the pro- vider’s records,

2.        That the provider is responsible to implement and main- tain a process to inform assigned members of the need to schedule periodic preventive dental services based on the member’s oral health status, and

3.        That the provider is responsible to complete any proce- dure undertaken upon a member if the contract is termi- nated or expires.

Historical Note

New Section made by final rulemaking at 8 A.A.R. 463, effective January 10, 2002 (Supp. 02-1).