04/02/2019

Promising changes for providers: Demystifying the state dental program


Dentists who want to better understand recent changes to the Medi-Cal Dental Program, including the substantial rate increases and a streamlined application process for providers, can attend a course this May at CDA Presents The Art and Science of Dentistry in Anaheim. The course is intended both for current and potential providers.

Due to the passage of the Proposition 56 Tobacco Tax in 2016, the state is dedicating over $550 million in new funds to provider reimbursements each year. The course, hosted by CDA Public Affairs and presented by the California Department of Health Care Services, will explain these reimbursements and more, including how to:

  • Participate in the state’s Dental Transformation Initiative, which offers incentive payments, including for treating children under age 6 (learn more about DTI expansions)
  • Code and bill accurately for the recently expanded adult benefits
  • Save time and reduce paperwork with the new Denti-Cal provider application and receive one-on-one assistance with enrollment or billing
  • Use the online provider portal to check treatment authorization and request claim status and payment history

The course will also discuss the new Proposition 56 Medi-Cal Physicians and Dentists Loan Repayment Program, which may repay up to $300,000 toward student loans for dentists who commit to serving Denti-Cal beneficiaries. Applications for the program opened April 1.

“Improving Oral Health of All Californians: Dental Transformation Initiative and More” will take place 12:30-2:30 p.m., Friday, May 17.

Read more about the course and speakers in the online program (page 62) or at cdapresents.com/anaheim2019.



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A new loan repayment program is available for dentists and physicians who provide direct patient care to Medi-Cal beneficiaries. Eligible dentists may apply through Physicians for a Healthy California to receive up to $300,000 to apply toward their student loans in exchange for a five-year service obligation as a Medi-Cal provider.

Dentists in 26 counties have a new opportunity to participate in the Dental Transformation Initiative to help improve dental health for low-income children enrolled in the Medi-Cal Program while receiving enhanced reimbursement by meeting specific incentive metrics. As part of California's 1115 waiver, the DTI focuses on high-value care, improved access to dental care, and the use of performance measures to improve the program through four “domains.”

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Through the improved Medi-Cal Dental Program, more than 13 million individuals are eligible for dental benefits, and a streamlined application and significant rate increases are prompting more dentists to join the program as providers. The changes follow years of action to improve the program, including CDA’s efforts to educate the public and policymakers about the importance of good oral health care. Jennifer Kent, director of the California Department of Health Care Services, in this Q&A discusses the program’s recent changes and what dentists can expect as providers.

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