Title
Approval of Case #20-3 Dental Request
Report
Issue:
Whether to approve payment for dental expenses for LEOFF 1 member.
Staff Contact:
Debbi Hufana, HR Analyst, Human Resources, 360.753.8149
Background:
The Board must decide whether or not to approve the request for upper and lower dentures for LEOFF 1 member. The charge for upper denture is $980.00 and lower denture is $1,370.00 for a total of $2,350.00. The Denture Provision in the LEOFF 1 Disability Policies & Procedures, 2018 Revision, allows for reimbursement at 50% of the lowest quote. The member submitted two quotes as required in the Policies & Procedures from the same Denture Clinic from two different providers in the Denture Clinic. The LOEFF 1 member purchased the dentures on 12/23/2019. The attached treatment plan includes an oral evaluation and 4 extractions which have been reimbursed by staff approval per the Policies & Procedures. The additional charge on the treatment plan for relining in the amount of $440.00 is work that will be preformed in 6 months. That charge is under the $600.00 annual allowance and can be staff approved at the time the claim is sent in for reimbursement.
This request is not in accordance with LEOFF 1 Disability Board Policies & Procedures which requires the member to submit the quotes prior to receiving services.
Attachments:
LEOFF Application for Payment of Services
Active Treatment Plan
Olympic Dental and Denture Clinic Statement
Reference:
Section III Procedures to Receive Benefits, H. Dental Benefits, 2 Denture Provision