Smile, California: Helping Medi-Cal members use their dental benefit

Outreach efforts also focus on recruiting, retaining providers

A campaign to increase Medicaid-enrolled members’ use of Medi-Cal’s dental benefit was launched in October by the California Department of Health Care Services as part of an integrated plan to improve the overall performance of the state’s dental program. The “Smile, California” campaign will educate eligible members about the free and low-cost services available to maintain good oral health and make it easier for members to access care. Outreach efforts also focus on recruiting and maintaining providers.

The Medi-Cal Dental Program covers routine, preventive and restorative care for more than 13.5 million members in California, but less than half of enrolled children and only about 20 percent of enrolled adults utilize these services each year. The program is delivered through either the fee-for-service plan (Denti-Cal) administered by DHCS contractor Delta Dental of California or through a dental managed care plan (in Sacramento and Los Angeles counties only).

Smile, California will help to meet the state’s goals to increase dental visits among all members, increase the number of children receiving preventive services and molar sealants, and increase the number of providers accepting Medi-Cal and the number of Medi-Cal providers taking new patients. Over 10,000 providers already participate in the Medi-Cal Dental Program. Smile, California seeks to add even more to match the increasing demand for dental services throughout the state.

“We want to remove any mystery around dental coverage, promote the benefits of regular dental visits, and at the same time grow the provider network so members can easily find the care they need and want,” said Alani Jackson, chief of the Medi-Cal Dental Services Division within DHCS.

A new, mobile-enabled member website is the centerpiece of the campaign. At Smilecalifornia.org and Sonriecalifornia.org — the Spanish-language version of the site — members can get the facts about the dental program, learn about covered services and oral health needs at every age and find a Medi-Cal dentist.

The new campaign and website were guided in part by research commissioned by DHCS and conducted earlier this year with more than 2,600 parents of child members. This research revealed that 90 percent of the parents surveyed knew Medi-Cal includes dental coverage, but they were less certain of the types of available services and that these services are free for children. The survey found that parents were aware that oral health is closely connected to overall health and were eager to take advantage of preventive services that guard against decay, such as sealants and fluoride varnish.

Recruiting providers

As part of the provider outreach efforts, the program now offers scheduled, one-on-one enrollment assistance to dentists and RDHAPs interested in becoming a Medi-Cal Dental fee-for-service provider. Providers can register online to schedule an appointment to help with their enrollment application. Also, new providers have reported that the recently revised provider enrollment application reduces time and paperwork, with average time from application to approval taking approximately 14 business days. And now available is a team of regional representatives who offer direct assistance to enrolled providers.

Providers are already receiving significant new reimbursements as allotted in the current state budget, which CDA President Natasha Lee, DDS, called a “thoughtful investment to improve access to oral health care for California’s most vulnerable people.”

“With one-third of Californians receiving dental care through Medi-Cal, greater member and provider participation will quickly add up to thousands of healthier smiles. This is a tremendous opportunity to have a positive impact on oral health status across California,” Jackson said.

Find more information about the Medi-Cal Dental Program online or contact Denti-Cal at 800.423.0507 or CDA Public Affairs at 916.554.4984. To automatically receive the monthly

Provider Bulletin and related communications, sign up for the DHCS email listserv.

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At the children’s dental clinic that Dr. John Blake runs in Long Beach, children as young as 2 or 3 show up with blackened teeth and swollen faces, unable to eat because of the pain and in need of whole mouth restorations. In California, tooth decay in children outpaces the national average. Hoping to save both teeth and money, the state is addressing the problem with an overhaul of Denti-Cal, part of the Medi-Cal health system for low-income Californians.

New state revenue from the taxation of tobacco products, along with support from legislators and Gov. Jerry Brown, is putting over half a billion dollars toward increased Medi-Cal dental provider reimbursements for 2018-19. The higher reimbursement follows years of activity to improve the Medi-Cal dental program and increase access to oral health care for California’s 13.5 million Medi-Cal members.