Sunday, July 20, 2008

Two Doral Dental Opinions: Both raise questions

When asked about signing up to be a Doral Dental Provider here are a few of the responses:

mc2001 says: I have mostly good things to say in Virginia. The rates are reasonable (reimburse at approximately 60-70% of my practice fees depending on the codes). I collected $2.8 million last year with 8 chairs running 5 days a week.

I get a $30,000-$45,000 check every 9-12 business days, very few claims get denied and they cover most ADA codes that a pedodontist uses. Additionally, I am a participating provider with Delta and once the participating provider adjustment is done, I often find that Medicaid reimburses at a higher rate than Delta.

Sounds like to me this guy (or gal) is saying they get more money from Doral Dental and it's Medicaid reimbursements, then through private pay Delta Dental. Do other dentists know about this, since they argue they won't take medicaid patients due to the low reimbursement rates?

Of course I did take note that is was all about the 'coding' used. Wonder what coding one uses to get that high of a percentage of reimbursement? Creative Coding maybe? Like coding on Oral Hygiene instruction which is telling a two year old to brush his teeth twice a day, (can't tell his parents, they are locked in the waiting room at many clinics) wonder how much that pays?

Of course there are two sides to the flattest pancake so here is another opinion from nanham22:

Run away AS FAST AS YOU CAN. Doral manages Kansas Medicaid and it is the reason we absolutely refuse to see Medicaid patients - we don't get paid on time - MAYBE six months later, if we are lucky; and then, minimal reimbursement.
You can never get anyone to help you with claims. Finally, we had to call the governor's office and our state rep to get claims paid that were over a year old.

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