Kansas Medicaid
Kansas Medicaid
I practice in Kansas, and when I first opened I took all new Medicaid patients. I eventually stopped taking new adults with Medicaid, and recently stopped taking new children with Medicaid. However, 3 years into it, I am still frustrated by "Kancare" on a daily basis. For kids, knowing what is covered is not so bad, as we know up to age 19, practically anything that is not cosmetic is covered. For 19-21, some people are covered, some not. Over 21, it only pays for exams, x-rays, extractions, and one MCO pays for one prophy a year while the other two MCO's will pay for two. This summer all reimbursements were lowered by 4%, and we have recently had a lot of "random denials". I am just getting frustrated with dealing with it on a daily basis, plus even after 3 years my FD lady is still just confused by it as I am. I am contemplating dropping it for any individual once they turn 19. Or even charging them, then reimbursing after Medicaid pays us. Is there anyone else from Kansas that can give me advice? Our "representatives" from either MCO are NOT helpful at all, as usually they don't know what Is going on either!!
Thanks:)
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KANSAS MEDICAID
GuerrillaDental Member Since: 05/15/07 Location: California
If you charge patient a dime you are committing a felony. I was charged for 6 felonies for charging Medicaid patients for root canals that were not eligible for reimbursement. Called Medicaid they stated I could charge patient if quoted prior to service. Wrong! DOJ did not care what Medicaid said to the office. Needed official denial of service before they said could charge patient a dime.
Ironically if we tried to bill Medicaid that would have been considered a felony also due to teeth non eligible for treatment. Moral of story don't ever take. Medicaid. You are stupid if you do. Read the statute.
Reth Member Since: 03/16/06 Location: Spearfish, SD
What does your local or state dental association say? Our state has been really good. Delta administers medicaid . . . but it helps when there's only 300 dentists in the state and I know the people in their office by name.
GuerrillaDental Member Since: 05/15/07 Location: California
It doesn't matter what your state association tells you or what the Medicaid call center tells you. You need to read the legal statutes.
The government accountability office did an investigation on Medicaid to determine what information they told doctors. 80 percent of what they told doctors and how they told them to bill claims Etc was wrong information .Each wrong billed claim or mistake is considered a felony.
Like I stated the DOJ. Does not care who told you what or when.
Richard1234 Member Since: 01/25/06
Everyone on DT should read this post TWICE.................it is so so so dangerous to accept medicaid. You had better document better than any dentist on the planet, and understand that the guidelines are often in flux ....or you are screwed.
alanrw Member Since: 05/16/11 Location: SoCal
The problem is the DOJ has a bunch of young gunslingers who are building their reputations as being "tough on crime". Dentists are the softest target on the planet (well, maybe 80 year old men in comas are a bit softer) and they get to put notches in their gun belts as part of their professional resumes. Out of curiosity, if Medicaid will not pay for an endo and the tooth is salvageable, what is the legal cannon that prevents a Medicaid patient from paying privately for treatment? Are Medicaid patients treated to a different level from the general population? Do they not have the same rights to enter into a contract as a free adult?
Were the stakes not so high, it would make a fascinating trial by a jury of one's peers to explore this lunacy.
mouthjanitor Member Since: 03/11/15
If you're on Medicaid you should have no resources to pay for it.