Local dentist withdraws as KanCare provider
By Scott Aust, The Garden City Telegram, Kan. | |
McClatchy-Tribune Information Services |
"The system is broken and needs to be fixed," Dr.
In a letter to KanCare and state officials about his decision, McVey said it is less expensive to simply give away his services rather than spend so much time seeking reimbursement from KanCare vendors.
In 2013, the state privatized
Frequently, vendors would claim they didn't receive or couldn't open attachments on claims, or would subsequently find the attachment, promise to reprocess the claim, and the practice would find out months later the claim was again denied.
In one instance, the office received a payment for a patient they had never seen. On other occasions, when KanCare should have been secondary insurance to a patient's primary insurance, a claim would get processed as if KanCare were primary, resulting in an overpayment that would take additional hours or days to sort out.
"It's an accounting nightmare,"
Apparently, the McVeys aren't alone in their frustration with the KanCare system. In late August,
The McVeys hope
"I don't understand why they thought having three vendors would be more efficient," she said.
In late May, the McVeys sent letters announcing the decision to withdraw as a provider to KanCare, effective in August, to the governor's office and several state legislators, including Garden City Rep.
"We caught so much heck about this thing, and I fought it and fought," Doll said. "Then I ended up talking to some people, and I think I ended up voting for it. I hated it at the start, but it was one of those things you get pressured like crazy, and it was my first year there."
Doll said typically when something is done to make as big a change as KanCare did, it's going to take some time to work out the kinks.
"But from everybody I've talked to, it's not getting any better," he said.
While Doll isn't ready to completely toss it out right now, he thinks it could use some work given the experiences of people like the McVeys. He isn't sure at the moment whether KanCare will be an issue for discussion during the next legislative session.
"A lot of it, I think, will depend on the election. I'm not trying to play politics or anything, but this election is going to have a say on a lot on the things that ALEC wanted, and this was an ALEC thing," Doll said, referring to the
"We're hoping to stir the pot a little bit I guess, hoping they will make some changes. I said before, the system is definitely broken. It's not working," he said. "It just seems like the right hand doesn't know what the left hand is doing."
After withdrawing from KanCare, McVey gave current patients three options: seek a new dentist who participates in KanCare, pay the full fee for service, or enter his new voluntary dental program.
"We were dealing with this frustration, and it never got better. We didn't want to turn our back on this population, so we thought about what we could do," McVey said of the volunteer program.
The voluntary dental program is only available to patients who have KanCare and were McVey's patients prior to
For example, if a dental appointment is 30 minutes or an hour, the patient or their family must volunteer 30 minutes or an hour for someone else.
Some of the opportunities to volunteer or perform community service mentioned in a letter given to patients about the program include serving through churches; organizations like the
"We don't put any kind of restriction on what they can do. They could do something for
While KanCare covered a few of McVey's adult patients, most of his KanCare patients were children. He said his practice lost a few patients who chose to find a dentist providing KanCare, but most of those who stayed thought the voluntary program was a good idea.
McVey estimated KanCare reimbursements added up to 5 to 6 percent of his revenue, and the time spent administratively chasing reimbursement was well out of proportion to that percentage.
McVey said KanCare only reimburses 30 to 50 percent of actual procedure costs. Spending so many hours of administration time trying to get reimbursement for so few dollars didn't seem smart, and led them to the conclusion it would be less expensive to give the services away.
"The ones I really feel bad for are the kids. If you've got a toothache or an infected tooth, you can't concentrate in the classroom. You can't enjoy recess. You can't eat properly. They're the ones that are paying for this ultimately," he said. "Do I think this (voluntary program) is the perfect solution? No. But we thought it was worth trying."
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(c)2014 The Garden City Telegram (Garden City, Kan.)
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