Medicaid Dentists Still Concerned About Provider Rights, Other Providers Concerned About Reimbursement Rates

Online surveyIn August, TDMR conducted its annual online survey of Medicaid providers.  This time, however, the focus of the survey was expanded from only dentists to all Medicaid providers to see how the two compare.  Completed surveys were filled out by 98 Medicaid dentists as well as four hundred and four other Medicaid providers, all who responded from our emails about taking the survey.

These other providers self-identified as follows:

Medical  34%
Mental Health   23%
Behavioral/Speech Therapy 20%
Home Care 15%
Durable Medical Equipment 6%
Transportation 2%

Major difference on biggest challenges providers face

A major difference in attitude between the two groups was found in answers to the first question “What are the biggest challenges Medicaid providers face today?”  Surprisingly, despite successes in the area over the last few years, dentists still consider provider rights “most important.” “Regulatory complexity” and “problems with MCOs” come next.

Provider rights 76%
Regulatory complexity 56%
Problems with dental MCOs (managed care organization) 56%

While other Medicaid providers were more focussed on reimbursement rates along with MCOs as “most important.”

Reimbursement rates 69%
Problems with MCOs (managed care organization) 50%
Reimbursement procedures 42%

It might very well be that dentists have grown concerned about rights again because dental MCO MCNA has been placing unsuspecting providers on payment holds apparently without due process.

Similar answers regarding biggest concerns over regulations and payment holds

In the other two questions regarding Medicaid issues, the most popular answers were remarkably similar.

The most concerning issue is “increased regulatory complexity” for both groups.  But again, surprisingly, all providers considered “being placed on a payment hold” a “most important” biggest concern, even non-dental Medicaid providers. There was no clue that this may be a consistent concern with all Medicaid providers.

“In your opinion, what is a Medicaid provider’s biggest concern?”

Increased regulatory complexity 60%
Being placed in payment hold 60%

Other Providers
Increased regulatory complexity 50%
Being placed in payment hold 50%

“When you have questions about Medicaid, where do you turn for guidance?”

State government agency 50%
Colleagues 47%

Other Providers
State government agency 53%
Colleagues 40%

Medicaid survey 2016

One Response

  • Providers Rights .

    We give away our providers right signing contracts with insurances including MCO..

    Who dictate the reimbursement rates are the insurances.

    Who regulates the policies are the insurances contracts.

    When providers stop being smart???

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