ABCD Enhanced Dental Fees

With the additional add-on fees for ABCD services, payments to dentists in Washington State have been raised to about the 6th percentile of Usual and Customary Rates.

Sample fees are:


If more than (1) one additional dental professional staff member is needed to protect patient from self injury while treatment is rendered, then behavior needs to be documented for reimbursement.

Bottom Line at the Dental Office

My name is Mary Jo. I work in Dr. Swell’s dental office at the front desk, and I was curious to see what the “bottom line” was for a child on the ABCD program. I followed one of our little patients for a year and then compared another child with just a medical coupon and another child with WDS insurance. Here’s what I learned:

Susie Q. Simpson first came to us when she was 6 months old. She had 2 teeth. Her mom had enrolled her in ABCD.

1st Visit: 6/22/99 Mom filled out Susie Q’s papers. She was taken to the chair. The assistant obtained the child’s history. Dr. Swell talked with mom and performed a first exam on this 2-toothed little one. The assistant applied the fluoride varnish. It took a second assistant to hold the little one so she was immobilized and would not hurt herself. She cried -- but it was over soon. Then the assistant spent 20 minutes with Mom showing how to “lift the lip” with a flip chart, discussing brushing and cleaning the mouth and obtaining a family dental history. Dr. Swell wrote a prescription for fluoride drops.



2nd Visit: 9/26/99 Mom brought in Susie Q. for her second fluoride varnish. She now has 8 teeth. The assistant applied the varnish, with the help of a second assistant.

3rd Visit: 3/23/00 Mom brought Susie Q. -- who now has 12 teeth. Dr. Swell performed a periodic oral exam. There was no decay. The assistant applied the third fluoride varnish, utilizing a second assistant’s help. The assistant provided the 2nd of 2 yearly oral health education sessions (20 min).

Conclusions:

• For the same-aged young child, ABCD paid 122.79 MORE than WDS paid!
• The office received $51.85 more for an ABCD child than one not enrolled in ABCD.
• It pays to have a child with a medical coupon, under the age of 5 years, enroll in ABCD.