FAQ

Capitol Dental Care (CDC) delivers dental care to members covered under the Oregon Health Plan (OHP). CDC is a dental care organization (DCO), and we contract with the Oregon Health Authority (OHA) and multiple coordinated care organizations (CCOs).

CDC has served OHP members since 1994. CDC has a track record of being "user friendly" and doing the right thing for our members.

You need to renew your OHP membership every year. You can renew your benefit over the phone at 1-800-699-9075 (TTY 711), or visit www.OregonHealthCare.gov to find a community partner in your area.

You should be reassigned to the same dental care network that has been providing your care. If not, contact your CCO and request to be transferred back to the provider of your choice.

It is important for you to have a primary care dentist (PCD). Click here to view a list of dentists in your area. (CDC can send you a free printed version of the provider list if you request one).

Call one of the dentists on the list and let them know you are a member of CDC and that you would like to be a patient in their office. If you have difficulty with this, call us so we can help you.

Once you have a PCD, give them a call when you are ready to make an appointment. You can also call us if you need help with this. Once you have an appointment, make sure you show up and arrive on time.

Your PCD may request for you to see a specialist through a referral. If you choose to see a specialist without getting a referral from CDC first, you may have to pay the bill.

It is also important to keep your appointment and arrive on time with any specialists that you are referred to. Specialists have very limited availability.

If you would like a second opinion, you can get one. Let your PCD know, or give us a call to help you get a second opinion.

If you have trouble getting to an appointment, you may be eligible for non-emergent medical transportation (NEMT). Call your CCO to determine if you can get help with NEMT services.

If needed, an interpreter will be provided for you. Your PCD can request one for you. You can also call Capitol Member Services for help.

Yes! Please talk with your PCD about your options, or call us to help you with this.

You do not have to pay for covered services from a participating dentist—but you will have to pay for services that are not covered. Your PCD should tell you if a service is not covered. You can also call us for help with understanding which services are covered.

Be sure to find out what an uncovered service will cost. Ask your PCD if there is a covered service that will meet your needs instead. If you do want an uncovered service, you will need to sign a form indicating that you will be responsible for the bill before you can receive any services.

If you get a bill for a service that you thought was covered, talk to your PCD. You can also give us a call with your concern.

If you are unhappy with OHP, CDC, your PCD, or the services you have received—you can file a complaint. A complaint is also known as a grievance.

You can get help filing a grievance. You can call us to file a grievance, or you can send an email or a letter with your grievance. Your CCO and OHP Client Services can also take your grievance.

If you requested a service, and that request was denied, you can ask for an appeal. You can do this by giving us a call or by requesting a hearing through OHP.

You will receive a letter that explains how to proceed. You must respond within 60 days from the date on the letter.

A law called the Health Insurance Portability and Accountability Act (HIPAA) protects your dental records and keeps them private. Your PCD will only share your records with those who need to see them for treatment and payment reasons.