Doral Dental has been operating as the administrator for the MassHealth Dental Program for just over a year now - so how are they doing?
In January 2008, the prior authorization system was streamlined – for children, this means that the majority of services no longer require a prior authorization. Faster service with less paperwork means healthier kids. (A flyer from Health Law Advocates [PDF] explains the changes to MassHealth Dental.)
Prior authorizations for adults have also gotten easier, but there are still many times when a MassHealth member needs Doral Dental’s "Intervention Services" to help shuttle them through the prior authorization or appeals process. Working with this part of their Boston office, members (and advocates) are able to submit documents in support of medical necessity and make sure approved services are processed.
There is, however, potential for this department to get overwhelmed with the 1.3 million MassHealth members trying to access care. Have you encountered any difficulties, or great success, with the "Intervention Services" office? What are you hearing from MassHealth members?