Program drives more demand for dentists

Posted: Monday, August 07, 2000

JUNEAU (AP) -- Some Alaska kids who can now afford dental checkups thanks to a new state program are having trouble finding a dentist because many dentists don't accept Medicaid.

When the state started a program called Denali KidCare last year, money began flowing for 11,000 more children to see dentists.

But that worsened an existing problem, said Brad Whistler, health program manager for the children's portion of the state Medicaid program. Not enough dentists accept Medicaid to handle the demand.

Denali KidCare is an expansion of the Medicaid program for children and pregnant women in families with incomes up to twice the poverty level.

''In Sitka now we don't have any dentists that are seeing new Medicaid patients,'' Whistler said. In Juneau, only two dentists are accepting new Medicaid patients, he said.

There also are problems in Kodiak and the Kenai Peninsula, he said.

In some cases the state has paid for children to go to other cities for care if it's not available locally.

Whistler said there isn't an overall shortage of dentists in Alaska.

''It is mostly a Medicaid, Denali KidCare issue,'' he said.

Medicaid is not a popular program for dentists, who complain the program doesn't reimburse them their full rate, has a cumbersome billing process and opens them up to audits.

''It's a multifaceted problem,'' said Martha Reinbold, executive director of the Alaska Dental Society.

Alaska's Medicaid program pays dentists more than most states, Whistler said, but it still pays less than federal or state employees' dental insurance.

For instance, Medicaid pays $114 to $151 for a routine checkup and cleaning, he said. That compares to about $170 his state worker insurance paid for his children's routine preventive care.

Also, Medicaid patients can be frustrating for dentists to work with because they are often less likely to show up for appointments, Whistler said.

Doug Weaver, president of the Juneau Dental Society, said that can be frustrating for a dentist who may have put off established patient to take care of a new Medicaid patient who doesn't keep the appointment.

''Everybody kind of loses -- your patient and the Medicaid patient because they're not there, and your office loses,'' he said.

Whistler said the higher no-show rate among poor families may be due to a lack of reliable transportation or day care.

Whistler said dentists also find it frustrating that low-income patients tend not to follow through on recommendations for improved hygiene and nutrition.

The state has been working with the Alaska Dental Society to try to come up with some solutions.

P.K. Wilson, provider and beneficiary services unit manager for the state, said the state is working on a better electronic claims submission process, and other ways to make the process smoother, she said.

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