Why Dr. Stubbs is a Medicaid Endodontist

Why Dr. Stubbs is an Medicaid Endodontist

I am proud to be a Medicaid endodontist.  My decision to accept Medicaid was made while I was in residency for my endodontic training.  I had just come out of the military and I was back on a student budget.  I had 4 small children and it was difficult to make ends meet.  It seemed like there was more month than money and I struggled to make ends meet.  My family was lucky to qualify for Medicaid assistance so we at least had healthcare...kinda.  It was difficult to find a quality doctor that accepted our Medicaid insurance.  Let's face it, the reimbursement is low and Medicaid can be sometimes difficult to deal with.

When I first opened my practice, I had a difficult time signing up to be a Medicaid endodontist, so I let the idea go for a while.  However, I hired a front desk who had some previous experience with Medicaid and I gave it another try.  The process was still difficult, but we completed it.  I now set aside a percentage of my practice specifically for my Medicaid patients.  There is a shortage of Medicaid endodontist in Colorado and I cannot treat everyone.  However, I feel that Medicaid is an underserved population and I try as hard as I can.  I treat every patient like I wanted my family to be treated when we were on Medicaid.

Overcoming Scheduling Challenges

There is a shortage of Medicaid endodontists.  This is a significant issue for Colorado and it doesn't appear that the issue will be solved in the near future.  It is impossible for me to treat every root canal in Colorado.  I have set aside a percentage of my practice to treat underserved populations and I will continue to advocate to my fellow endodontic professional the value of being a Medicaid endodontist.  However, until more endodontists appreciate the importance of serving underserved population, there will continue to be longer waiting times to become a patient of our practice.

Navigating Medicaids Policies and Procedures

It can be difficult to navigate Medicaid's policies and procedures, but we have done our best to work within the system.  We have developed an office system that allows us to deal with Medicaids policies most effectively.

Referral for Medicaid

Following policies outlined in Medicaid's "Office Reference Manual Colorado Medicaid Dental Program", we require a referral from your general denstist to inform us of their initial assessment and what treatments they are requesting that we complete.  Please make sure to bring your referral to your appointment.  If you would like to use x-rays previously taken at another dental office, please have your dental office send the x-rays before your appointment.  Otherwise, we can take new x-rays in our office.

Initial Exam for Medicaid

We preauthorize all of our root canal treatments with Medicaid.  On your first appointment, we will review your x-rays and complete an examination for the referred area.  Afterwards, we will review your Medicaid benefits with you and explain your coverages.  After your initial exam, we with preauthorized your treatment with Medicaid.  If your treatment was previously preauthorized with a different dental office, they will need to "drop" the previous preauthorization before scheduling your appointment.

Treatment for Medicaid

After you become a patient of our practice, there is no difference in treatment or scheduling for patients who pay using their Medicaid benefits.  You can schedule an appointment any day that we are open and whenever there is a time slot unoccupied by another patient.  I give the same care that I wanted my family to receive when we had Medicaid.

Dental Benefits for Children in Medicaid

Child enrollees are covered Medicaid's  Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.  Oral screening is part of a physical exam, it does not substitute for a dental examination performed by a dentist. A referral to a dentist is required for every child.

Dental services for children include:

  • Relief of pain and infections
  • Restoration of teeth
  • Maintenance of dental health

Dental Benefits for Adults in Medicaid

States determine what dental benefits are provided to adult Medicaid enrollees.  Most states provide emergency dental services for adults, but less than half of the states currently provide comprehensive dental care. There are no minimum requirements for adult dental coverage.

Are you eligible? 

                                 

Program Eligibility and Application Kit