Many dentists are hesitant to participate in Medicaid or Medicare programs because of low reimbursements and administrative hassles.
Four dentists recently spoke with Becker's to discuss the changes they'd like to see from the two programs.
Editor's note: Responses were lightly edited for length and clarity.
Huzefa Kapadia, DDS. Kapadia Dental Care (Waterford, Mich.) and Detroit Sterling Dental: It would be great if they would be faster in approving root canal/core and crown treatment. Seems like the system is bogged down, sometimes [I have] to wait over a month to get approval. By that time, the patient goes elsewhere and has the tooth removed.
Harry Papadopoulos, DDS, MD. Richmond (Ind.) Oral Surgery Associates: I do not participate in Medicare. The very low fees combined with all the work that has to be put in by my staff for reimbursement are the reasons. Recently, Medicare has gotten involved with dental insurance, which my practice has stayed away from for similar reasons. I get at least four to six calls a day from patients asking if we take Medicare plans or if we know anyone who does. I feel bad for the senior citizen population, but I also have an obligation to protect my practice and ease the burden of my front desk staff whose job keeps getting more difficult on a daily basis just dealing with the commercial insurance plans we participate in.
I do take Medicaid. Timely reimbursement has not been a problem, which is a big plus, but fees have been chronically low even with recent increases. Indiana had a 10% increase in fees recently but that does not make up for lack of fee increases in 15 years. Recently, commercial insurance companies have gotten involved with Medicaid in my state, causing confusion and added work for my staff trying to verify benefits and collect reimbursement thereafter.
For a solo practice, the above is a burden that is only getting worse. The programs need to:
1. Make their fees more competitive (Every doctor understands that the reimbursement will be low but the fees should at least keep pace with inflation).
2. For Medicaid, cut out the third party. I don't see any good coming out of commercial insurance companies getting involved in the process.
Todd Sarubin, DDS. Sarubin Family Dental (Pikesville, Md.): If Medicare could offer some benefit toward folks over the age of 65, it would be great. I know they don't have a ton of money to put toward dental, but I'm sure patients would greatly appreciate the help.
With Medicaid, I haven't accepted it in over 30 years. I take one new patient each year who I offer free dentistry to after they have applied and been approved by the Donated Dental Program of Maryland, which was started by a classmate of mine at the University of Maryland in 1985. I'd rather do dentistry for free than deal with the headaches and red tape associated with getting $3.00 for a filling. I don't know how to fix that. Also, there seems to be a lot of abuse by professionals taking advantage of Medicaid and I don't like that at all.
Andrew Wang, DDS. Olympia Fields Dental Associates (Matteson, Ill.): I believe Medicare and Medicaid programs should increase their reimbursements for bread-and-butter dental procedures. Medicare dental reimbursement rates have not increased since the pandemic. Dentists are observing an increased cost from dental suppliers after the pandemic. Unfortunately, we cannot increase the cost to our Medicare patients.