Helping DSOs Bridge the Dental Divide with Teledentistry

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It’s always interesting to read about dentistry in the mainstream media and get their perspective on our somewhat insular industry. I recently came across a 2016 editorial entitled, “DSOs Illustrate How the Private Sector Can Solve Public Health Problems.”

In this article, author Wayne Winegarden takes a no-holds-barred approach in his opening paragraph, “Delusions that increased government control will heal what ails the U.S. health care system continue to fester. Private dental organizations are illustrating that it is private sector innovations, not increased government regulations, which have the power to improve the U.S. health care system.”

The sad reality is that access to coverage does not equal access to care. This is demonstrated by the fact that the majority of private practice dentists do not accept Medicaid or Children’s Health Insurance Program (CHIP) plans.

However, at the same time, DSOs are stepping up to bridge what is called the dental divide – the socio-economic disparity that exists between those with access to oral healthcare and those who don’t.

Why is this? Largely because many private practice dentists can’t afford to treat Medicaid patients. It’s not that they don’t care, but with average reimbursement rates 60-cents on the dollar, roughly two-thirds of American dentists are simply not interested in accepting Medicaid patients. Those who do may later regret it thanks to “continuity of care” laws that mandate that once you accept a Medicaid patient, you must continue treating them – even if you are taking a beating financially.

Many DSOs on the other hand, represent a free market driven innovation thanks to their efficiencies and processes which contribute to their ability to survive on those reduced Medicaid reimbursements. Combine this with their highly efficient business operations, which enable them to navigate through the cumbersome paperwork that is typical of government programs.

What’s more, the fact that most DSOs are marketing machines helps them offset their Medicaid patients with a steady stream of insured or fee-for-service patients who are seeking high-priced cosmetic and restorative services.

In another example of the private sector solving public sector problems, a study by national Medicaid analysis firm Dobson DaVanzo found that expansion of the DSO model in select states could generate enough savings to bring dental care to an additional 1.9 million Medicaid patients every year without increased government spending.

There’s no denying that DSOs have had a major positive impact on public health dentistry, but what if there was a way to dramatically increase – perhaps double – the amount of Medicaid patients DSOs can examine, document, treat and provide with dental homes?

There is a way with teledentistry – especially when using the TeleDent all-in-one teledentistry platform.

Squeezing More Profit from Slim Margins

TeleDent provides two must-have options that will make serving Medicaid patients more time efficient, which means more cost-effective.

These options are synchronous (real-time video) and asynchronous (store and forward) methods of clinical data collection, which includes diagnostic images, videos, clinical notes, and treatment plans.

In other words, integrated process flow and sharing of images, x-rays, videos, and clinical notes can occur either in real time or when available, making case collaboration simple and cost-effective, even when busy specialists or labs need to be involved.

Conquering Government Red Tape

One way to prevent government bureaucracy is to improve the efficiency of your internal operations. Teledentistry can enable DSO headquarters, administrators, individual practice managers, practitioners and clinicians to closely coordinate on the administrative and clinical matters pertaining to Medicaid patients. The result is that the Medicaid patient’s treatment plan can easily move forward from acceptance to completion to reimbursement.

The TeleDent platform also improves Medicaid claims management by HIPAA-compliant sharing of information such as patient consent and treatment plan acceptance, completion of procedures, and before and after images – which Medicaid administrators increasingly want to see.

Managing Medicaid Across Multiple Offices

The high cost of clinical staff payroll that remains constant despite low Medicaid reimbursement rates, makes it essential to monitor case workloads, acceptance rates and other practical measures of business performance. TeleDent helps keep track of multiple offices, and external collaborators within the DSO networks to help identify and correct inefficiencies when treating Medicaid patients.

Medicaid Beyond Your Office Walls

Many Medicaid patients will not be able to come to your office locations due to reasons such as lack of transportation, physical disabilities or living in a nursing home. Teledentistry enables you to send care team representatives to visit them.

For example, DSOs that operate in a state that allows remote supervision of hygienists by dentists, can expand their reach among the Medicaid patient population by establishing satellite hygiene clinics.

Another option is establishing pop-up screening clinics which can serve more Medicaid or private insurance patients. For example, free oral health screening clinics under your DSO’s brand can be set up in community settings such as shopping malls, health fairs, or even senior centers. Pop-up screening clinics can be staffed with hygienists (in states that allow it) and/or your newer dentists.

For best results, satellite hygiene clinics and pop-up screening clinics should be located within reasonable driving distance of a DSO location for that office to take full advantage of the restorative and periodontal treatment referred by the hygienists.

Teledentistry delivers the connectivity and efficiency that can have a positive bottom line impact when applied to care for Medicaid patients. Imagine the results when applied to serving the rest of your patients.

Written by Brant Herman
Brant Herman is the CEO and Founder of MouthWatch, LLC, (www. a leader in innovative teledentistry solutions, digital case presentation tools and intraoral imaging devices. The company is dedicated to finding new ways to constantly improve the dental health experience for both patient and provider. Contact Brant at

Read other Mouthwatch articles:

The Group Dentistry Now Show: Podcast interview with Mouthwatch’s Brant Herman

What Do Group Practices and DSOs Expect from Teledentistry?

Expanding DSO Business Models via Teledentistry

An Out-of-the-Box Teledentistry Solution to Growing Pains caused by Rapid Dental Group Practice Growth

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