A dentist recently contacted TDMR with a problem that his practice, a group practice, has come across with the new requirements for placing Medicaid children under general anesthesia.
Difficulty with multiple dentists doing treatment
The new general anesthesia requirements are nearly impossible for a group practice with multiple dentists doing exams and different doctors doing treatment. They are looking for one signature that must do treatment. If a doctor is not working that day, the patient must be canceled and scheduled for a different day. This is tricky when you are scheduling anesthesiologists, patients, and doctors with a population that no-shows 25% of the time and cannot be sick to be treated. Also, some doctors never work certain days, but work other days. It is an absolute obstacle to care.
Managed care denials
In relation to reimbursement via dental managed care, he went onto charge that a certain dental managed care company has:
“created a huge blockade for group practices treating kids under general anesthesia. Treatment needs pre-auth, giving them a chance to frequently deny appropriate treatment on carious lesions and they require numerous signatures on multiple forms, which are impossible to get right if you have multiple doctors practicing. If one doctor does the exam and one does the treatment, only one can sign for the treatment but if it is one and not the other then it will be denied.”
Let us know
If, as a dentist, you are finding similar problems, please let TDMR know.