How is Doral Dental doing with MassHealth members?

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June 16, 2008 - 10:28am - Georgia Maheras - Health Law Advocates - Boston

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?

BMC/Dural plan type 2

Omgosh, it’s been 3 mo. and I still haven’t found a provider to get my teeth cleaned and fixed. I've been searching online and nothing is affordable. Yeah, 15% off but I can’t afford that. Can some one please help me find an AFFORDABLE Dental plan.

Re: BMC/Dural plan type 2

If you have Commonwealth Care but do not have dental benefits covered, you may be able to get dental care covered by the Health Safety Net at a Community Health Center. You can find a listing of Health Centers here:


I have Commonwealth Care plan I and Doral Dental. My medical insurance is absolutely wonderful. But the dental insurance? I have always takwn good care of my teeth, usually paying out of pocket, but now I am avoiding having my teeth taken care of because both times I went to a Doral provider it was absolutely horrible. The first time the office was FILTHY and I mean that, I won't go into details. So I switched to another 35 minutes away and the dentist really hurt, botched a filling, my tooth ended up cracking, now I need a root canal but I don't know where to go. I am scared to do anything.

mass good choice

I lost my Job No insurance and thought, thank god for Mass Health-But After today I am kicking myself for going and using a Doral Dentist. I broke my tooth monday and got an appointment on Wed with an approved dentist. Man I was repulsed. the place was gross-There was a drunk guy being treated- It was ghetto, I digress. So I go in for just this tooth. He says no problem. I didnt want a cleaning but he said to do it because it was "covered" and by the way the broken was is not. So he said he was just going to file it a bit so it wasnt sharp and I could get it pulled under the insurance but not capped. THEN HE PULLED THE REST OF THE FILLING OUT so it would not get infected and sent me away. 800 out of pocket for a cap. The insurance only caps front teeth so i am screwed. Big hole in my tooth. I would rather not have insurance then have half assed ghetto coverage.

Denture problem

Just curious to find out if there is anything that I can do to get the procedure done to put what I was told picks into your jaws to hold your dentures in place? I am on Disablitly and basically told low income. I have a horrible problem with my dentures because I have very little gum to hold them into place. Nothing but this procedure can be done to help me my dentist told me. I have to use the denture paste glue to hold them in and if I take one bite of food that has and hard or very chewy consistency to it my dentures fall out. I don't enjoy eating out with friends at all and am almost always without my dentures around my own home because of this. I can't eat much of anything unless it is very soft and pliable. It is making me extremely depressed over having to continuously take my teeth out. I can hardly eat any fresh foods like fruit or veggies because of it and I am a diabetic so am generally eating a lot of sweet foods because it is usually those type of foods that don't have any kind of texture to hurt my gums since I don't wear my teeth becuase they come out so easily and often. I am 61 years old and not wanting them for my looks but for my health. Is there any way I can get any kind of help in obtaining these very expensive implants to help me??
Thank-you very much for your help and advice. Just asking as I was always told it NEVER hurts to ASK..
Again, Thank-you!!
Your Friend in need,
May 31,2009 12:06 AM.

re: Denture problem

Dear Robbe,
If MassHealth is refusing to cover this service, you might try calling the Health Care For All Helpline at 1-800-272-4232 to see if it is possible to file an appeal. Another resource is legal services; they also help with MassHealth appeals (a directory of their offices is available at

It seems obvious, from reading your comment, that new dentures with implants would enormously improve your health. However, I am not sure what MassHealth covers. If it isn't possible to get the dentures you need by filing a MassHealth appeal, you may also want to try calling the Massachusetts Dental Society at 1-800-342-8747 to see if they have any leads. I'll also email you this info.
I hope this helps,


A good dental benefit is something that people and everyone could make use without any hassles or problems. People responsible for providing this should be more aware and address the issues revolving around their patients and members. Their memebers should also know to what extent their coverage is.

As I see it, the major

As I see it, the major problem is the fact that we do not have a single-payer system. I think we are moving towards this with recent legislation in Massachusetts, so I am hopeful.

Hi my name is Natasha and I

Hi my name is Natasha and I have limited Mass health, but how ever I have three root canals that need to be done.Do you accept mass health. Thank you

Re: Hi my name is Natasha and I

Hello Natasha,
It sounds like you need to talk to someone who is used to working with the MassHealth dental system and could give you advice for your individual situation. I recommend calling the Health Care For All helpline at 1-800-272-4232.

Or, if you email me at landerson @, I may be able to find someone in your local area who could help you get it figured out.
Hope this helps,

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