Information from the California Victim Compensation Program
Dental Services Play Vital Role in Benefits Available from California Victim Compensation Program
Crime often strikes without warning. An unexpected death by violence, a shooting, a sexual assault, child molestation or domestic violence complicates the healing process for victims, survivors and family members. Crime can leave families emotionally, physically and financially devastated.
The California Victim Compensation and Government Claims Board can help crime victims and their families' access resources to cope with the aftermath of violent crime. Every year, thousands of people turn to the Victim Compensation Program for help with paying the cost of their crime related dental expenses.
Working with the Program
If you are a dentist providing services to a victim of violent crime, you may want to consider referring your client to an advocate at your local victim assistance center for help with the program's application process. In most counties victim advocates are part of the District Attorney's office. In addition to benefits through the Victim Compensation Program, advocates can connect crime victims with a host of other services. Applications are available at http://vcgcb.ca.gov/victims/.
If you are currently working with a client who has already applied for compensation from the program, the following information will help ensure your bills are paid efficiently:
- Include your client's application number on each bill. If your client does not know their application number, they can call 1-800-777-9229, or their local victim advocate for help.
- Include verification of your licensure and a completed IRS Form W-9 when you submit your first bill to the Program.
- All bills must be submitted on an approved American Dental Association (ADA) form. Required information includes treatment description and procedure codes, your license number and your federal tax identification number.
Fast and efficient payments to providers of dental services for crime victims are a top priority of the Program. To this end, our claims management system continues to be refined to ensure an expedient turn around time on provider bill processing and payment. We have also included the following enhancements to make it more convenient for providers to work with the Program
Dental Preapproval Process
Dentists can submit a dental pre-determination/authorization to the Program. The pre-treatment estimate should be submitted on a completed ADA form; however, some dental offices use their own computer generated pre-treatment estimate forms. These are acceptable; however, the ADA Dental Claim form or computer generated forms must include the following information:
- patient name and address;
- provider name and address;
- provider tax I.D. and license number;
- CDT - Current Dental Terminology codes and description of services;
- charges for each procedure; and
- total charges.
Once the pre-treatment estimate is received, it will be reviewed to determine if the treatment is medically necessary and related to the qualifying crime. If the pre-treatment estimate and crime report information is not sufficient to make a determination additional information may be requested from the dental provider.
If treatment is approved or denied, a notification letter will be mailed to the provider and victim.
Leader in Providing Services
California has been a leader in providing service to victims of violent crime for over 40 years. California was the first state to establish a Victim Compensation Program in 1965. The program has since paid nearly $1.8 billion to help victims of crime and during the 2007-2008 fiscal year, the program paid out $1.3 million to cover dental expenses for crime victims.
In addition to dental treatment costs, the program can also pay for services such as medical, mental health, funeral and burial, rehabilitation, income and support loss, and relocation benefits.
The program is not funded by taxpayer dollars. Instead, it is funded by fines, fees and penalties paid by state and federal criminal offenders.
The California Victim Compensation Program invites you to share all of this information with your colleagues. The more providers who are aware of the program, the more victims will be able to find quality dental services.