Medicaid Switch Still Causes Glitches In Pa.
By David Bruce, Erie Times-News, Pa. | |
McClatchy-Tribune Information Services |
The northern
"No one was taking new clients in
The Van Ord children have been seeing
But recent changes to
"I'm afraid that by the end of November, a significant number of our patients will be cut off from dental services," Shapter said.
Shapter said the problem started when the
Families either enrolled or were automatically assigned a plan by
"We didn't know about the change until we took our son to the doctor,"
"They asked for our new card, and we had no idea what they were talking about,"
Medicaid recipients in northwestern
But dentists and physicians have faced more obstacles. They must be credentialed and sign contracts with the managed-care companies to be reimbursed for their services.
"We have been trying to get credentialed since
"I already was credentialed by
The DPW agreed to a 60-day grace period in which doctors and dentists who accept
But that grace period runs out
"I don't see that as a problem with Dr. Shapter," said
Shapter and Lovelace said reimbursement is a separate issue.
The
"We are asking for adequate reimbursement," Shapter said. "Our costs have not been addressed in 12 years, though our expenses have gone through the roof."
Lovelace said UPMC For You pays a higher rate than traditional
Other dentists and doctors are going through the same process with
But the lack of pediatric dentists in this area who accept
Instead of arranging transportation to
"When you tell families around here that they need to go to
The fear is that children with extreme decay develop life-threatening infections, Shapter said.
"It's rare, but I have seen examples locally," Shapter said.
The Van Ords hope that Shapter is able to continue treating their children. They recently took 71/2-month-old Alexander to his first dental visit.
"We might have to look into something, but the kids love it here,"
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