Dental Consultant Services

The New Hampshire Department of Health and Human Services, Division of Medicaid Services, is seeking qualified vendors to provide dental benefit administration and remote dental consultation services for NH Medicaid recipients aged 1 to 21. Under the direction of the DMS Dental Director, the selected contractor will perform remote clinical reviews of dental records and radiographs to evaluate medical necessity for prior authorizations, provide treatment recommendations, and support operational tasks such as processing suspended claims and managing MMIS-related deliverables. Additional responsibilities include assisting with policy development, conducting annual fee and utilization reviews, and reporting CDT code revisions in accordance with American Dental Association standards. The contractor must hold an active New Hampshire Doctor of Medicine in Dentistry or Doctor of Dental Medicine license in good standing. The contract is structured with an hourly rate of 115 dollars, inclusive of travel and mileage, with a maximum of 650 hours per full State Fiscal Year. Anticipated funding is 43,125 dollars for 2027, and 74,750 dollars for both 2028 and 2029, with the possibility of extending the agreement for up to four additional years. Award selection is based on the overall highest scoring vendor, focusing on experience and capacity rather than low cost. The agreement is subject to various federal and state regulations, including 2 CFR 200, the Civil Rights Act of 1964, and NH RSA audit requirements. Compliance measures include mandatory information security management systems to protect patient data and the requirement for vendors to provide a Unique Entity Identifier via SAM.gov.