For many years, the Wisconsin Dental Association’s legislative agenda included an ask for a multi-county pilot that would test the effects of increased reimbursement rates on reducing barriers to care for patients. Gov, Scott Walker heard the WDA’s arguments for testing this approach and included a four-county pilot in his 2015-2017 state budget that raised rates for pediatric and adult emergency treatment codes in Brown, Marathon, Racine and Polk counties.
If you are a dentist in one of these four counties, participating in the pilot is a great way to help both patients and your profession. WDA worked with the state to ensure that as many codes were covered as possible and that the rates paid are viable. In most cases, these rates are now comparable to what is paid by commercial insurance.
Many dentists hesitate to participate in the MA program because of a past bad experience, or are unsure how to balance their practice by adding more patients. Still others prefer to volunteer at local clinics or to give free dental care through their practice. These are all wonderful avenues, but the reason MA participation matters is because charity care is not officially tracked. We survey our members every few years to get a general idea of how much care they give away, but the truth is we have no idea how much care is provided. The MA program is the metric by which the state measures access, so when Medicaid patient encounters go up, dentistry gets credit for seeing more patients in need.
Fair or not, that is the system we have to work in.
One of the biggest hurdles we constantly hear about is dentists who quit the program or do not wish to participate because of paperwork or lag time in payments. Today’s MA system is very different from that of the past. Everything now runs through an online portal and turnaround time on claims is about two weeks.
Improved efficiency leads to an easier workload for office staff and dentists themselves. Even better—there is no additional signup to participate in the pilot. If you are a registered Medicaid provider in these counties, you automatically receive the higher rates when you bill.
If you are in Brown, Marathon, Racine or Polk county and have thought about signing up, NOW is the time. If you were a MA provider in the past but dropped out, NOW is the time to give the program another chance.
Please contact me with any questions or for more information at [email protected] or 608-250-3442.
