Dr. Ghazaleh Nouri of Magnolia Modern Dental Serves Those in Need of Low-Cost Dental Care While Also Serving the Needs of the Practice

Practice Growth

A native of Hamburg, Germany, Dr. Ghazaleh Nouri earned her DMD from the University of Hamburg in 2011. Following her marriage and relocation to the U.S., she furthered her education at Loma Linda School of Dentistry, attaining her DDS. She eventually founded Magnolia Modern Dental in Riverside, California, offering a comprehensive array of advanced cosmetic and general dentistry. The practice has thrived, growing to a team of 11, including two traveling specialist doctors distinguished in periodontics, implant surgery, and endodontics.

One of the hallmarks of Magnolia Modern Dental is the attention to detail that shapes every aspect of the business – from customer service and overall experience; to top quality state-of-the-art dentistry; to
the aesthetics of their patients’ smiles; to extended hours, payment options, and insurance coordination. This attention to detail uncovered that one critical success measure was not keeping pace with the others: the insurance aging report was growing, and the number of unpaid claims specifically related to Medi-Cal Dental was increasing rapidly.

Getting a Grip on Collections

With high front office staff turnover, Dr. Nouri had also come to realize that repeatedly having to recruit,
hire, and train new people on Medi-Cal Dental was more than she bargained for. As if private dental insurance billing isn’t complicated enough, Medi-Cal Dental has different and more specific procedures and requirements around such things as pre-authorizations, aid codes, forms, and attachments – all of which many of even the most experienced billers are unfamiliar with.

In December 2023, Dr. Nouri decided to seek outside help in the dental insurance billing arena. Although not a Medi-Cal Dental Provider, her brother – the owner of a dental practice in the same area – highly recommended the eAssist Dental Solutions associate company with whom his office had been working for some time. As one of the only dental billing companies trained in Medi-Cal Dental, Dr. Nouri turned to this eAssist associate team for help, especially with her office’s backlog of those challenging claims.

As explained by the eAssist billing team lead, “It entailed some real heavy lifting up front, but the bulk of the old Medi-Cal Dental claims was cleaned up within five months at a 92% collection rate. Since then, these claims have basically been in ‘maintenance mode’ – collections have held steady and healthy, with no increase in over 90 claims.”

Medi-Cal Dental Claims – the first 5 months

When that associate team joined eAssist in April 2024, so did Magnolia Dental. The billing team could now focus more on the myriad PPO insurance plans, achieving a collection ratio of 114% on all claimsover the next seven months.

All Claims – the next 7 months

“eAssist’s expertise in dental billing has been a game-changer for our practice. Our team has successfully
cleaned up old Medi-Cal Dental claims, reduced over-90-day accounts, and streamlined the processing of
claims and pre-authorizations. Thanks to their efforts, our collections now consistently exceed 95%.
Moreover, they’re professional, reliable, and a pleasure to work with.” – Masoud Roueintan, CFO

The Medi-Cal Dental Opportunity: Assessing ROI

Each individual practice owner must evaluate the financial and non-financial pros and cons of being a Medi-Cal Dental Program provider. Before shying away from becoming a Provider because you question the ROI, these are some points to consider when discussing with your business advisors:

●The Medi-Cal Dental Program enrolled about 14.9 million members in December 2023¹, providing an enormous pool of potential new patients. Once accepted as a Provider, the online Provider Directory helps members find their California practice with just a few clicks. In addition, an 800# Telephone Service Center is available to provide additional help to those unable to find a dentist in their area.

●The additional requirements and complexities of Medi-Cal Dental necessitate having a billing team – whether in-house or a third party – that is experienced in the special nature of Medi-Cal Dental claims to help ensure your practice is being fully reimbursed for all that is rightfully owed. If done by a third party, you can reasonably expect to pay a somewhat higher fee per claim, due to the additional expertise and effort required to work those claims and achieve a high collection ratio.

For example, Section 5 of the Medi-Cal Dental Program Provider Handbook – titled “Manual of Criteria and Schedule of Maximum Allowances” ² – comprises 237 pages of policies and procedures, CDT codes and descriptors, and maximum fees allowable for covered services by age group. Your billers need to be well-versed on all that, and on how to maximize those particular collections.

If you use a third party that charges fees based on results achieved, the slightly higher fee for working Medi-Cal Dental claims should prove well worth it due to the improved collections you should expect.

● Consider the indirect benefits that come from enhancing your reputation in the community as a doctor/practice owner who cares about those less fortunate, and is willing to accept a lesser reimbursement for high-quality dental care because you believe it’s the right thing to do. That reputation and demonstrated good well is likely to generate additional new patients that come with even higher financial ROI through private insurance carriers.

In-House vs. eAssist Billing Team – 5-month cost comparison