The purpose of the program is to provide essential dental services to transplant candidates and individuals with kidney failure to ensure that they are infection and pain free. Transplant candidates in need of dental clearance are encouraged to complete all other testing before applying unless they have oral pain or infection.
Initial approval covers the initial exam and assessment. The patient must make a $10 co-payment to the dental provider at the time of each visit. This copayment is in addition to the fees paid by NKF AZ.
Arizona licensed dentists will provide all treatment.
Qualifying Services:
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Essential dental services are defined as treatment delivered to eliminate dental caries and/or alleviate pain, infection, swelling and/or injury. This includes periodontal procedures such as scaling/root planing; basic restorative procedures such as fillings; oral surgical procedures such as extractions; and endodontic procedures such as root canals.
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Non-essential dental services are defined as prosthetic procedures such as dentures, crowns, and partials. Non-essential procedures will be placed on a waiting list for periodic review and approval by the Patient Services Committee.
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This program does not pay for expenses related to dental treatment under general anesthesia (for example, physician charges, operating room fees, anesthesia, and recovery room fees).
Eligibility (In addition to the General Eligibility Requirements above):
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Patients with dental insurance are ineligible for NKF AZ dental assistance.
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The dental provider must agree to the guidelines of the NKF AZ Dental Program and its fee schedule, which is based on the current AHCCCS Dental Fee for Service Rates and Codes: https://www.azahcccs.gov/PlansProviders/RatesAndBilling/FFS/Dental.html
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The dental provider must agree to accept the NKF AZ payment as payment in full (except for the patient's $10 co-payments).
Forms:
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Initial Exam:
- To start a new Dental Assistance application use
https://www.GrantRequest.com/SID_6273?SA=SNA&FID=35031 - To access a saved or previously submitted application use https://www.GrantRequest.com/SID_6273?SA=AM
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Financial Statement (if not already completed within the last six months for other assistance requests)
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When transplant work-up is not involved, a letter explaining why the need for dental care is required.
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Treatment Assistance:
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After the initial exam, a treatment plan must be submitted to NKF AZ, along with full-mouth x-rays, for approval before any dental assistance is provided. All treatments must have prior authorization from NKF AZ.
Renewal:
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N/A