In The News
Maryland Healthy Smiles Dental Program
Dear MSDA Members:
As many of you may know, effective July 1, 2009, DentaQuest (formerly Doral Dental) has become the sole administrator for the Maryland Healthy Smiles Dental Program which provides dental coverage for some of the most vulnerable people in the state. I have recently joined DentaQuest as the Executive Director for the Maryland dental program. My role is to ensure programmatic success by collaborating with all of the constituents across the state including the provider community, the member community, government officials, the Department of Health and Mental Hygiene (DHMH) and DentaQuest. I wanted to take this opportunity to provide some key information to the MSDA members on DentaQuest and changes with the Maryland Healthy Smiles Dental Program. I’d also like to encourage you to participate in this new program if you are not already doing so.
For those of you who are not familiar with DentaQuest, let me start there. DentaQuest is the largest government benefits administrator in the country. We focus on government benefits administration in Medicaid and Medicare and cover over 11 million members in 24 states and the District of Columbia. We currently are responsible for 7 statewide dental carve-out programs in IL, TN, VA, MA, ID, SC and MD. We also work with nearly 60 Managed Care Organizations (MCO) across the country. Our mission is to improve oral health of the residents in the regions we serve through dental benefit administration, creation and transfer of knowledge and philanthropy.
We are extraordinarily excited to have been awarded the state contract to administer benefits for the new Maryland Healthy Smiles Dental Program. This program was established to provide Medicaid coverage for children under age 21, pregnant women 21 years of age and older, and adults enrolled in the Rare and Expensive Case Management (REM) program. As the dental benefits administrator, we have been tasked with increasing provider participation and member access to care, streamlining the administration for providers and members, and establishing a “dental home” for every member in the state by year three.
To achieve these goals, we have worked with DHMH to make some key enhancements to the program to benefit participating dentists and the patients you serve.
New Provider Resources
DentaQuest has created several resources to ensure participating providers have the support they need. A new Office Reference Manual has been created to provide detailed information on processes and procedures associated with the Maryland Healthy Smiles Dental Program. In addition, the Provider Web Portal (PWP) is available 24/7 to verify eligibility of your patients, enter and submit claims directly to DentaQuest, view status of submitted claims and run reports to verify claims submission. A dedicated toll-free number for Maryland Providers has been created and is staffed with Call Center Specialists available Monday - Friday, 7:30 AM – 6:00 PM.
A Local Team
DentaQuest has established a Maryland based team to ensure that provider and member needs are addressed. The team includes the DentaQuest Dental Director, Dr. Hakan Koymen and four Provider Relations Representatives assigned to every dentist in the state. In addition, we are working to hire an Outreach Coordinator to facilitate events around the state to educate members on the importance of proper oral health.
Streamlined Administration
DentaQuest and DHMH have also worked to streamline the administrative processes with this new program. We have grandfathered in many existing Medicaid providers to eliminate the need for cumbersome application processes. For new providers joining Medicaid, we have also streamlined the provider application and credentialing processes. To ensure the claims submission process is simplified, DentaQuest offers several flexible options for claims submission. We recognize the importance of fast and accurate claims reimbursement to dentists so we have moved our adjudication cycle to weekly and also offer Electronic Funds Transfer (EFT) for payments to dentists. Finally, we are also increasing the level of member outreach to ensure patients know the importance of making and keeping dental appointments.
New Fee Schedule & Cost Saving Opportunities
The Maryland Healthy Smiles Dental Program comes with a new fee schedule that is standard for all participating dentists in the state. In addition to increasing fees for some preventive services, there have also been enhancements to the oral surgery and endodontic fees. DentaQuest has also established a dental supply discount program for participating providers to assist with costs associated with delivering care.
As we move forward with the Maryland Healthy Smiles Dental Program, I look forward to communicating with you on a regular basis. I hope that you will consider participating in this program. We’ve got a tremendous opportunity to help the Medicaid members in Maryland. Let’s work together to make the Maryland Healthy Smiles Dental Program one of the best in the nation!
Sincerely,
Tequila Terry
Maryland Executive Director
DentaQuest
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