DentaQuest is receiving a flurry of complaints accusing the company of making access to care more difficult since Jan. 1, when it began providing dental services to Medicaid-eligible children in Tennessee.
The controversy centers on dentists who weren't included in its network. Charlotte Kenyon of Inglewood said the company failed to adequately help her find a replacement dentist for her grandchildren. A Youth Villages representative said the organization is disappointed that DentaQuest ended mobile dental lab services to group facilities. And the Tennessee Dental Association has rescinded its support for DentaQuest having the TennCare contract.
DentaQuest is also under fire from black dentists, who accused the company in a hearing this week before state lawmakers of weeding out dentists who saw high numbers of TennCare patients.
One Nashville dental practice is asking federal court to intervene. Snodgrass-King Pediatric Dental Associates has sued DentaQuest and TennCare, but documents in the case are under seal.
Kenyon called The Tennessean, saying she could not get a person on the line when she called the DentaQuest service number to find a replacement dentist.
"If this isn't a blatant attempt to discourage services, I don't know what is," Kenyon said.
That accusation also comes from dentists, who note that DentaQuest will receive a bonus of up to $8 million from the state if it reduces costs while providing treatment to at least 50.6 percent of TennCare enrollees.
The board of trustees for the Tennessee Dental Association in its March newsletter raised "concerns that this incentive may result in reduced care for the children in the TennCare program."
DentaQuest says it exceeds standards
Citing numbers, DentaQuest said it is outperforming requirements in the state contract it was awarded through a competitive bid process.
Kristi Gooden, a spokeswoman for DentaQuest, said the number of screenings has increased during its service and noted that it takes 11 days to get a routine appointment when the contract requirement is 21 days. DentaQuest has 864 dentists in its network — one for every 857 patients, which she said exceeds nationally recommended standards.
"While we respect those who are raising concerns and who may have not been invited into our network, at the end of day the facts show that the new network is working very well," Gooden said.
Dr. Barry Rolin, who has offices in Inglewood and Goodlettsville, said no longer being in the TennCare network adds up to a loss of 30 to 40 percent of his revenue.
The change to a new provider also meant the end of mobile services to group homes for children in state custody.
"We have been disappointed that DentaQuest has so far not added a mobile dentist provider," said Connie Mills, a spokeswoman for Youth Villages. "For safety and continuity of care, it's much better for kids receiving help on our residential campus to get dental care on the campus."
DentaQuest said it held meetings with state officials to map out a plan to ensure these children received dental care.
"We also believe it's important for children retained in state custody to be treated in and afforded a dental home, not necessarily a mobile home," Gooden said.
Bush Family Mobile Dentistry, which had provided services to 24 facilities throughout the state, went out of business. Shane Alvis, who was its general manager, said there's a public safety issue because some children in state custody have criminal backgrounds and violent tendencies. Dr. James Bush said children in state custody are also among the most vulnerable.
Reach Tom Wilemon at 615-726-5961 and on Twitter @TomWilemon.