Please Get Educated about the 2010 Healthcare Act

A decent summary of the Affordable Healthcare Act (ACA) as it impacts dental patient care was released recently.

The ACA has inadvertently developed many complicated twists and turns for patients and providers on the long road to a successful, comprehensive care horizon.

My thoughts:

1) Dentistry isn't about to get cheaper or easier to access with the advent of the ACA activity.

2) Maintain great communication with your employers and human resources representatives. Do your best to communicate the continued need for dental insurance policies.

3) Consider a health savings account or a flexible spending account and talk with your employer or HR about matching or funding those accounts for dental care. These types of accounts allow flexibility in how and where you get care. They can also help you and your family break through dental insurance limitations for where, when, and how you get care.

4) Educate yourself on how you can keep your children healthy under the ACA provisions. Odds are there is a state-funded program for kids in need, wherever you may live.

5) The ACA will create better access to medical insurance for our country's patients. Keep in mind surgical care in a dental office (tooth extractions, periodontal surgery, grafting, dental implants) and treatment for sleep apnea in a dental office can be submitted to medical insurance.

Maybe medical insurance...?

We cannot guess what reimbursements exist for medical applications in dentistry. We have to rely on many resources and colleagues to help us over the hurdles when patients ask us to help them wade through the medical claims arena.

We have improve our relationships with medical insurers over the past 5-10 years. We now see a more common reimbursement for temporomandibular (TMJ) therapy, head pain therapy, implant surgery, and a few other services. But it's not a guarantee. Every patient has a different policy with different terms. But we do check, and we notice the climate for medical reimbursement is a bit more sunny for patients than it used to be.

Recently, the pharmaceutical company Allergan invited me to sign on to a Botox reimbursement service. Allergan has counselors who do the homework on behalf of head pain/TMJ patients who want to submit requests for medical reimbursement. The first encounters with the process have been positive.

I was unaware that patients have the potential to receive significant help with payment for Botox therapy as it relates to chronic pain, like migraine, TMJ, and intractable muscular tension pain in the head and neck. WHen I read the summaries from the counselors for my own wife, I was upbeat. There is coverage that can be preauthorized.

So I am inviting patients who want treatment with chronic head, jaw, and neck pain to consult with our office. I always take the position that our patients prepare to make full payment for the therapy. But the potential for reimbursement is more of a reality today.