Apple Health dental reimbursement rates increase – State of Reform
Reimbursement rates for almost all services covered by Apple Health increased by 100% on July 1.
In the 2021 legislative session, Washington state lawmakers set aside $ 76 million in its 2021-23 budget to improve access to care through an increase in fee-for-service reimbursement rates for Medicaid adult dental patients.
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Washington State’s dental Medicaid prices are among the lowest in the country, according to the Arcora Foundation, Washington Delta Dental Foundation. This makes it difficult for suppliers to participate in the program. Reimbursement rates have not increased in Washington State since 2007. Prior to this increase, Medicaid reimbursement rates were about 32% of the total cost of providing services, compared to a national average of about 50%. .
Arcora writes that:
“The bottom line is that Apple Health dental coverage, while essential, does not always equate to access to care. These new and increased reimbursement rates for Apple Health adult dental services show real progress in our state’s commitment to improving equity in oral health.
Vanetta Abdellatif, President and CEO of the Arcora Foundation said the following:
“Low-income Washingtonians and black, Indigenous and colored populations face far too many barriers to accessing necessary dental care, exacerbating health disparities. The increased investment in the Medicaid Adult Dental Program is an important step towards building a stronger program that can bring our state closer to equity in oral health.
Dentists who already accept Apple health insurance automatically started receiving increased reimbursements from last month. Apple Health covers a number of dental procedures ranging from routine checkups and annual cleanings to dental extractions and fillings, among others.
Arcora Foundation in partnership with Washington State Dental Association the to encourage dentists to register as Apple Health providers. Statewide, 29% of people are covered by Apple Health, but fewer than four in ten have seen a dentist in the past year, according to the Arcora Foundation.
Alison Mondi, director of policy for the Arcora Foundation, said other ways to help dentists get into the Apple Health network include providing resources, Medicaid system training, and billing assistance.
“I think that as we look to the future we want to build on these investments and build a more sustainable program,” she said.
Dentists who sign up as Apple Health providers can also sign up for DentistLink, Arcora’s free referral service that directs patients to care. Dentists who accept Apple Health can decide how many adult Apple Health patients they see in their office.