FAQs

What are my dental benefits?

Your ODS Community Dental plan covers preventive care such as cleanings, fluoride, X-rays and sealants. Your plan also covers fillings, extractions, root canals and dentures. For details about your dental benefits, talk to your dentist, or call ODS Community Dental customer service. You can also review the benefits section of your Member Handbook.

Do I need to find a new dentist?

Yes. You need to find a primary care dentist (PCD) near you, and call the office to schedule a new patient visit. Do not wait until you are in pain to call your PCD. Make the call as soon as possible so you can become a patient with your PCD. It is critical that you become a patient with a PCD so they can provide emergency dental services after hours.

What is a dental emergency?

A dental emergency requires treatment right away. Here are some examples:

• A tooth has been knocked out
• Severe mouth swelling or infection 
• Severe tooth pain that keeps you from sleeping or does not stop when you take over-the-counter medicine such as aspirin or TYLENOL®

How can I find a dentist for me and my family in our area?

Search our online provider directory or call ODS Community Dental customer service at 800-342-0526 for help finding a dentist.

What should I do if I have a dental emergency after hours?

Once you are a patient of a PCD, you can call them after hours for help with emergencies. Your PCD will respond to your phone call 24 hours a day, seven days a week.

I am covered under a different dental plan and want to transfer to ODS Community Dental. What should I do?

Call ODS Community Dental customer service at 800-342-0526 or your Coordinated Care Organization (CCO). They will help with your request.

Why did I receive a “Confirmation of Dental Services” letter from ODS Community Dental?

We sometimes send a survey to make sure our members received the dental services reported by their dentist. It’s helpful for you to complete the questions and return the form to us.

I have a dental appointment today. Who should I call to make sure it’s covered?

Call ODS Community Dental customer service at 800-342-0526. If your dentist asks you to pay a copay for your visit or a service, don’t pay it. Ask your dentist to call ODS customer service at: 800-342-0526 (TDD/TTY: 711).

Why did I receive a “Notice of Action Benefit Denial” letter?

This letter was sent to you to let you know that a dental service was denied. If you think the service should be covered, follow the instructions in the letter. Call ODS Community Dental customer service at 800-342-0526 for help.

Why did I receive a member satisfaction survey?

We would like to know more about your experience with your ODS Community Dental dentists. Your answers will help us make our dental plan better. We appreciate the time you take to complete the survey and mail it back in the enclosed envelope.

What are my rights and responsibilities?

See your Member Handbook.

I need help getting to my appointment. How do I schedule a ride?

You can call the ride service in your area. Ride services are provided at no cost to you.

Do you offer interpreter services for my appointments?

As part of your Oregon Health Plan benefit, a professional interpreter is available to you at no cost. When scheduling a dental appointment, ask for an interpreter. If you need help scheduling an appointment contact ODS Customer Service at 800-342-0526. ODS offers additional language access resources.

Can I get a second opinion?

Yes, a second opinion is available at no cost to you. Call ODS Community Dental customer service at 800-342-0526 for help finding a dentist who can see you for a second opinion.

Do I need a referral?

If you think you need to see a provider other than your primary care dentist, ask your dentist first. They will tell you if you need to see someone else (like a specialist). Your dentist can then write you a referral.

Do I need pre-approval?

A pre-approval or prior authorization is a document that says ODS will pay for a service. Pre-approvals may be required for hospital dentistry and is required for orthodontic services. ODS does not ask for pre-approvals for any dental services in the dental offices. For some specialty dental care services, such as oral surgery or wisdom teeth extractions, we may require you be seen by a dentist to get a referral before you can get the service.

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