In California these are primarily populations that are poor, low-income, minority, with half preferring languages other than English. The largest portion of the program serves patients on Medi-Cal. The program allows Borrego to provide a reimbursement rate to the dentist that is often more than double what the provider would recapture if they billed Denti-Cal directly as a private Medi-Cal/Denti-Cal provider.
Borrego Community Health is a 30-Year Old Federal Qualified Health Clinic
The program allows the dentist to expand the range of services provided to patients not covered by the Denti-Cal program (including Crowns, Root Canals, Adult Dentures, and more.) No Pre-Authorization for necessary dental care.
11,670,308 people are currently enrolled in Medicaid just in California. The program allows the dentist to expand the range of services provided to patients not covered by the Denti-Cal program (including Crowns, Root Canals, Adult Dentures, and more). There are no pre-authorization requirements in this program. This system is based on the importance of long-term preventative dental care.
Borrego Community Health remits the payments and PHCM handles the heavy lifting for you. The dentist's office staff does NOT have to handle the billing process with Denti-Cal. The dentists provide the patient care information, an encounter form, and Medi-Cal eligibility to submit to PHCM. Borrego processes all the billing with Denti-Cal and then remits premium payment to the dentists in a timely manner, within 3-4 weeks from date of submission.
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