Tuesday, November 22, 2016

DentaQuest Back in the Texas Medicaid Business?

Is DentaQuest back in the Texas Medicaid business?

Apparently so.

According to DFW Dental Team, who operates out of the newly licensed (Sep 2016) DFW Children’s Surgery Center dentist can “refer” patients and right there on their very interesting website is a link to DentaQuest forms.

161122-DFW Dental Team - DentaQuest screen shot




There is so much more to this story so expect an indepth look VERY soon.

Just for a sneal peek, let’s just say it involves a couple of Harvard grads (Brian Walker and Jonathan Jardine),  some Brigham Young University grads, a very proud Harvard professor and a bunch of dentists whom I would say are ethically challenged; a former Kool Smiles dentist, Dr. Diaa Zora and another “owner” dentist,  Dr. Ketan Sukkawala, being just two of the many.

It involves several business names such as:

North End Health Care http://www.nehc.com/ (Note the Harvardesque logo)
North End Capital, LLC Eagle, Idaho
Blue Cloud Pediatric Surgery Centers http://txcpa.lookupbook.net/blue-cloud-pediatric-surgery-centers-llc-houston-tx
HCDC Professionals, PLLC
San Antonio Children’s Ambulatory Surgical Center http://sachildrenssurgical.com/
SACS Professionals, PLLC
San Antonio Dental Team http://sadentalteam.com/ (ignore the statement that the surgery center is owned separtely)
DFW Children’s Surgery Center http://dfwchildrens.com/
DFW Dental Team http://dfwdentalteam.com/ (ignore the statement that the surgery center is owned separtely)
Referral Care, Inc http://www.nehc.com/affiliates.html

If you can’t wait you can check out:

North End HealthCare: Pediatric Ambulatory Surgery Center Expansion Strategy (don’t miss the disclaimer on page one)

Oh, and at the end (Strategic Decision) where Brian is asking himself questions..the answer is not only no, but hell no!

Friday, November 18, 2016

Broken Arrow, OK: Mother questions dentist's decision to cap, fill more than a dozen baby teeth at Super Smiles Dental

BROKEN ARROW - A Broken Arrow mother reached out to 2 Works for You after a popular Broken Arrow dental practice presented her with an estimate for more than $5,000 to fix her toddler's baby teeth.

Sarah Powell said she felt like she had failed her three-year-old son, Jaxon, when a dental practice told her he had 13 cavities in his temporary baby teeth.

"I was mortified," Powell said, "I couldn't fathom how he could have that many issues and no pain."

Powell said the dental assistant at Super Smiles Dental Office in Broken Arrow rattled off a list of work Jaxon needed and numbers Powell needed to call, then stopped and said, "Oh, you have private insurance. This is going to be expensive," according to Powell.

Because Powell said she had been regularly brushing Jaxon's teeth since they popped up, and that she took him for regular check-ups since he was 18 months old, she sensed something had to be wrong.

Read entire story here

Super Smiles - Broken Arrow-OK-logo


Despit Super Smiles logo, it doesn’t seem to be exactly a “Fun Place For Teeth”, does it?

Wish I could report EVAN D CLOTHIER DDS, was some sort of corporate dentistry thug, but I can’t. I guess he’s just a thug.  His Oklahoma dental license is current and there are no reported sanction listed. But that doesn’t mean much since so often they are never reported by the dental board.

EVAN D CLOTHIER DDS-Super Smiles-Oklahoma

Tuesday, November 15, 2016

TEXAS: 10.45% Reduction in Medicaid Reimbursement to Ambulatory Surgery Centers Likley To Be Catastrophic for Pediatric Dental Patients

On Wednesday of this week (November 16, 2016) at 1:30 there is to be a public hearing held by Texas Health and Human Services (THHSC) in the Brown-Heady Building, 4900 North Lamar Blvd, Austin, TX. The purpose of the public hearing is to receive comments related to a 10.45% reduction in reimbursement to Ambulatory Surgical Centers for Dental Rehabilitation and Restoration. My sourse says this reduction is spear headed by the Dental Service Organizations (DSO') whose target patients are children on Medicaid and is to take effect January 1, 2017.

(Why aren’t these “hearing” held at a time when the actual public or interested parties are available? It shall be interesting to see who is there to offer “public comments”.  THHSC website indicatged the hearing will be webcast and available to watch here: http://legacy-hhsc.hhsc.state.tx.us/news/webcasting.asp.)

The source states the long term plan is to reduce the number of licensed pediatric dentists and oral surgeons from accepting children who currently require sedation for treatment, whereby those dentists will drop out of the program thereby limiting the access to quality care for the children. This is outrageous!

I’m told the DSO's plan to hire young new graduates carrying loads of student debt general dentists to perform these procedures, The source hinted a system is already in place to make sure all children meet the qualifications to require sedation.

As it was told to me, it is planned to be much like the orthodontic scam that took place in Texas just a couple of years ago whereby nearly all children suddenly qualified for braces and the per-authorization process was to rubber stamp and approve every child!

(Let’s not forget how dentists were trained on how to scam the system by Dr. James (Jim) Orr and attorney Robert (Bob) Anderton, in Anderton’s private office.  Orr, at the time was Dental Director of the claims agent for Texas. In sworn testimony before the State Office of Administrative Hearings (SOAH) witnesses stated Orr and Anderton taught them how to “utilize” the HDL scoring system in place to qualify children for orthodontic braces. In addition the processors, who worked from home, were paid $50 for each approved application! For more on there click here.)

No doubt the Ambulatory Surgical Center’s are not going to complain too much about a reimbursement rate reduction when they expect their patient volume to skyrocket. Win, Win for everyone, right?  Well except the children who are needlessly sedated for what is likley to be unnecessary dental procedures, like 4 year old Navaeh Hall who was left brain damaged or Daisy Lynn Torres or 3 year old Marvelena Rady who both died this year.

For the public who would like to make comments by mail:

Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, TX 78714-9030

Overnight mail, special delivery mail, or hand delivery:
Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, TX 78751
Phone number for package delivery: 512-730-7401
Fax: Attention:  Rate Analysis at 512-730-7475


Related Links:

November 16, 2016 Hearing Briefing Package
Link to Webcast page

Thursday, November 10, 2016