HADLEY — Delays in getting reimbursements for MassHealth Dental patients remain a challenge for Hampshire Meadow Family & Pediatric Dentistry, more than two months after the practice considered suspending accepting appointments over concerns with the state’s new third-party vendor.
Contending that the system of processing claims by BeneCare Dental Plans is not close to being back to normal, Cyrus Safizadeh, who runs the Hadley practice, said there is continued failure in the system, even as some “advanced payments” are coming, though these are for work completed long ago.
“We are still seeing MassHealth patients, however, because they are making us emergency advanced payments, but these were set to expire June 30, from my understanding,” Safizadeh said.
Around $150,000 in advanced payments have come to the practice, but these cannot be allocated since the actual claims have not been processed.
Other issues with BeneCare have been that only a small portion of the actual claims are processed and wrongful denial of claims, Safizadeh said.
“It has become mentally taxing for me and many of our colleagues,” Safizadeh said. “Seeing MassHealth patients with the low reimbursement rates is hard enough, and this just is so frustrating.”
In late May, trustees for the Massachusetts Dental Society sent a demand letter to Michael Levine, assistant secretary for MassHealth, urging that improvements be made.
That letter suggested “immediate and decisive action to resolve this critical issue. We demand that all claims submitted before April 20, 2025, be reimbursed in full by Wednesday, June 4, 2025. The unresolved payment backlog is not a minor inconvenience, it represents a direct threat to the survival of the MassHealth dental network and the patients who depend on it.”
“These delays are imposing an unbearable financial burden on dental practices across Massachusetts, practices that provide essential care to the most vulnerable in our communities,” the letter stated.
Previously, a spokeswoman for the state’s Executive Office of Health and Human Services and MassHealth said the issues with processing and payments was “entirely unacceptable” and that fixes would be made, and that dental providers would be offered interim support, as needed.
Scott Merzbach can be reached at smerzbach@gazettenet.com
