Patterns in Pediatric Medicaid Dental Claims and Payment Amounts: An Analysis of Settings and Dental Providers.

Journal of Allied Health Pub Date : 2025-01-01

Katherine Mommaerts, Indrakshi Roy, Cassandra Bonah, Natalie Reznicek, Denise Muesch Helm

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引用次数: 0

Abstract

Objective: To determine the trends in the settings and types of providers that provide oral health services to pediatric patients using Medicaid in Arizona.

Methods: In a retrospective descriptive study, we examined the place of service and provider type of Medicaid-paid dental claims among pediatric patients from January 2016 to December 2019. We analyzed Medicaid reimbursed dental services using dental claims data.

Results: More Arizona children aged birth to 21 were treated in health clinics than in private practice/dental support organization settings in 2019 than in 2016. Preventive and minor restorative dental claims were significantly higher in 2019 than in 2016 for pediatric patients in Arizona. Further, there was an increase in dental claims paid to non-dentists, such as dental hygienists and nurse practitioners, in 2019 compared to 2016.

Conclusions: The place of service and provider type are shifting among pediatric Medicaid patients in Arizona. Not only is there a shift from place of service, but preventive and minor restorative dental claims are being filed by more non-dental providers. This reveals the movement towards integrated oral health in primary care for pediatric Medicaid patients in Arizona.

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儿童医疗补助牙科索赔和支付金额的模式：设置和牙科提供者的分析。

目的：确定亚利桑那州使用医疗补助为儿科患者提供口腔健康服务的提供者的设置和类型的趋势。方法：采用回顾性描述性研究，调查2016年1月至2019年12月儿科患者医疗补助牙科索赔的服务地点和提供者类型。我们使用牙科索赔数据分析了医疗补助报销的牙科服务。结果：与2016年相比，2019年亚利桑那州出生至21岁的儿童在健康诊所接受治疗的人数多于在私人诊所/牙科支持组织接受治疗的人数。2019年，亚利桑那州儿科患者的预防性和轻度修复性牙科索赔明显高于2016年。此外，与2016年相比，2019年支付给牙科保健员和执业护士等非牙医的牙科索赔有所增加。结论：亚利桑那州儿科医疗补助患者的服务地点和提供者类型正在发生变化。不仅服务地点发生了变化，而且越来越多的非牙科提供者提出了预防性和小型修复性牙科索赔。这揭示了运动向综合口腔健康初级保健儿科医疗补助患者在亚利桑那州。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allied Health Medicine-Medicine (all)

CiteScore

1.00

自引率

0.00%

发文量

期刊介绍： The Journal of Allied Health is the official publication of the Association of Schools of Allied Health Professions (ASAHP) . The Journal is the only interdisciplinary allied health periodical, publishing scholarly works related to research and development, feature articles, research abstracts and book reviews. Readers of The Journal comprise allied health leaders, educators, faculty and students. Subscribers to The Journal consist of domestic and international college and university libraries, health organizations and hospitals. Almost 20% of subscribers, in the last three years, have been from outside of the United States. Subscribers include the World Health Organization, the American Medical Association and major universities.