TDMR is pleased to announce that we received confirmation today from Texas Health and Human Services that, as of yesterday, DentaQuest is no longer paying a one-surface fee for non-interproximal two-surface fillings and will be reprocessing previously denied claims.
Win for Medicaid dentists
Tiffany Young, the agency’s deputy chief public relations officer, sent the following.
“HHSC has been in discussions with DentaQuest. As of Sept. 23, 2024, DentaQuest has changed its system to reflect that two surface restorations not involving an interproximal surface downcoding policy has been discontinued. DentaQuest is in the process of identifying claims for reprocessing.”
Must be vocal to get change
Complaints by dentists to the agency have been successful in getting this harmful payment policy of DentaQuest discontinued and getting the company to pay providers back for previously disapproved two surface claims.
This proves the necessity for Medicaid providers in general, not just dentists, to be vocal about needed changes in the system and not just sit back and let the system roll over them. It is your system, too.
Congratulations on being heard!
Congratulations to all of you Texas Medicaid Advocates for public healthcare!
As of yesterday (10/3/2024) when we called about a 2 surface filling payment we were told to send in the x-rays and they would reconsider payment. Nothing has changed. Filling was an OB on tooth #30.
Please contact the Texas HHS dental director Dr. Ensy Atarod at Ensy.Atarod@hhs.texas.gov. Anyone else affected should as well.