1 / 8

Dental Summit

Dental Summit. Presented by: Sheldon Wolf Assistant Medicaid Director North Dakota Department of Human Services April 14, 2000. Medicaid in North Dakota. Eligible recipients per month 22,000 children 20,000 adults Fee-for-service program Use ADA claim form

shea-buckley
Download Presentation

Dental Summit

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dental Summit Presented by: Sheldon Wolf Assistant Medicaid Director North Dakota Department of Human Services April 14, 2000

  2. Medicaid in North Dakota • Eligible recipients per month • 22,000 children • 20,000 adults • Fee-for-service program • Use ADA claim form • Extra compensation for dentists who treat DD clients • Prior authorization for prosthodontics, orthodontics, and oral surgery

  3. Medicaid inNorth Dakota • Electronic claims submission available • Claims turn around 10 days

  4. Medicaid Dental Benefits • Children (Age 0-21 years) • Covered under EPSDT (Health Tracks) • diagnostic • preventive • restorative • limited orthodontics • limitations on endo, prostho, perio, and oral surgery • cleft lip/palate treatment covered • Reimbursement - 85.7% of billed charges

  5. Medicaid Dental Benefits • Adults (over 21 years of age) • Covered services • Diagnostic • Preventive • Restorative • Some limitations on endo, prostho, and oral surgery • Periodontal treatment • Reimbursement - 72.3% of billed charges

  6. Medicaid Dental Strategies to Improve Access • Major fee increase in Dec. 1997 (shown in billed charges) • children - 70.7% to 85.7% • adults - 65.5% to 72.3% • Result • Increase in provider participation rate - 3.4% • Percentage increase in number of recipients served - 14.6% • Percentage increase in of number of services provided - 14.3% • Net Result - stabilization of the program

  7. Current Medicaid Dental Statistics • Annual budget - $4.95 million • 2000 Projected Expenditures - $5.4 Million (13% Increase from 1999) • Medicaid Recipients - 42,000 • Average Number Receiving Dental Services a month - 2,720 (6.5%) • 19,707 recipients received service in calendar year 1999 • 10,894 Children • 8,813 Adults • Average Cost Per Recipient - $326

  8. Healthy Steps Information • April Enrollment - 1,524 • October - November 1999 • Average Enrollment - 448 • Preventive Services - 252 • Restorative Services - 53 • Periodontics/Surgery - 14 • Other - 44

More Related