Complaints about dental benefits provider mounting

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

The rumblings in Tennessee started earlier this year, after a new company took over the contract to provide dental services to the state’s children covered by Medicaid.

Now the state dental association, a number of black dentists, a youth-home operator and at least one angry grandmother are weighing in against the Boston-based dental benefits giant DentaQuest. They claim the company is making it harder for poor kids in the state to get dental care.

The Tennessean’s Tom Wilemon captured the mood in a June 6 story, “Complaints Mount about TennCare Dental Provider:”   

“The controversy centers on dentists who weren’t included in its network,” Wilemon explained.

“Charlotte Kenyon of Inglewood said the company failed to adequately help her find a replacement dentist for her grandchildren. A Youth Villages representative said the organization is disappointed that DentaQuest ended mobile dental lab services to group facilities. And the Tennessee Dental Association has rescinded its support for DentaQuest having the TennCare contract.”

In addition, Wilemon wrote, “DentaQuest is also under fire from black dentists, who accused the company in a hearing this week before state lawmakers of weeding out dentists who saw high numbers of TennCare patients.”

Kenyon contacted the newspaper complaining she could not get any help in finding a new dentist for her grandchildren when she called the DentaQuest service number.

“If this isn’t a blatant attempt to discourage services, I don’t know what is,” the grandmother contended. “That accusation also comes from dentists, who note that DentaQuest will receive a bonus of up to $8 million from the state if it reduces costs while providing treatment to at least 50.6 percent of TennCare enrollees,” Wilemon wrote.

In a June 4 story, Chas Sisk, also reporting for The Tennessean, covered a hearing where black dentists aired their complaints about DentaQuest to state legislators. Several dentists said that after DentaQuest took over the state contract, they had been purged from the list of providers approved to treat TennCare patients without being given an explanation or the chance to appeal.

In a statement offered to WREG-Memphis, which also covered the hearing, DentaQuest officials said no child with TennCare benefits has lost access to dental care.

Meanwhile DentaQuest spokeswoman Kristi Gooden told The Tennessean that the number of screenings has increased since the company won the contract and that its state network of 864 providers – one for every 857 patients – exceeds nationally recommended standards.

“While we respect those who are raising concerns and who may have not been invited into our network, at the end of day the facts show that the new network is working very well,” Gooden told the newspaper. She said the company’s process for assembling its network is confidential, but that ethnicity was not a factor in selecting providers.

 

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