How do the new enhanced Medicaid rates compare to commercial insurance companies?

Although we cannot get into details of any specific insurance plan, if you review the enhanced rates for the pilot to one of your contracted insurance plans, you will see they are quite comparable. The WDA thinks it’s important to note that with pilot reimbursement rates that fall similarly in line with commercial contracted rates,… Continue Reading How do the new enhanced Medicaid rates compare to commercial insurance companies?

If I become a Certified Medicaid Provider, must I then abide by the new ACA rules for Section 1557 that state I must provider a language translator to Medicaid patients if they ask for one?

Yes, you would then have to abide by this new regulation IF, and only IF, the patient asks for a language translator then you must accommodate the request. However, the ADA and the WDA have worked to make this requirement as easy to implement as reasonably possible. You can find additional information on 1557 via… Continue Reading If I become a Certified Medicaid Provider, must I then abide by the new ACA rules for Section 1557 that state I must provider a language translator to Medicaid patients if they ask for one?

Is the process of filing claims and getting paid by Medicaid still as cumbersome as it has been in the past?

Since the state developed ForwardHealth and the Medicaid portal, the process of becoming a Certified Medicaid provider and filing claims became more seamless. Everything you need to know about being a Medicaid provider, claims, coverage benefits and reimbursements is all located online and in one place now. The creation of the Dental Unit has also… Continue Reading Is the process of filing claims and getting paid by Medicaid still as cumbersome as it has been in the past?

Is there any mandate for the state to collect data on the pilot counties and make that public?

Although our original proposal dictated what data parameters to collect and when, the Governor did veto that out of the bill. However, the Department of Health Services, Oral Health Program obtained grant funding from HRSA to do data collection on the pilot. DHS will be contracting with UW Population Health Institute to collect and publish… Continue Reading Is there any mandate for the state to collect data on the pilot counties and make that public?

What happens when the state runs out of money that is allocated to the pilot? Do the enhanced rates just stop then?

It is our hopes that the state does in fact run out of the $13.7 million allocated because that would mean more children are being seen, more emergency adults are being seen and more dentists are signing up to be Certified Medicaid Providers. The state cannot stop reimbursing at the enhanced rates even if the… Continue Reading What happens when the state runs out of money that is allocated to the pilot? Do the enhanced rates just stop then?