Grow Your Practice With the Improved Medi-Cal Dental

If you’ve ever considered participating in California’s Medi-Cal Dental program, there’s never been a better time to take a closer look. Thanks to recent improvements that expand patient access, increase reimbursement rates, and open new opportunities for dental providers, Medi-Cal Dental offers both financial and community-impact rewards for your practice.

What is Medi-Cal Dental (formerly Denti-Cal)?

California’s Medi-Cal Dental, an arm of the state’s Medi-Cal Medicaid program, serves nearly 15 million low-income beneficiaries, including families, people with disabilities, seniors, children in foster care, and pregnant women. Patients receive a wide range of free or low-cost dental care, including diagnostic, preventive, emergency, and restorative care, along with complete or partial dentures. With overall health being so tightly entwined with good oral health, this sweeping program helps keep California residents strong and smiling.

How Many Dentists Participate in Medi-Cal Dental?

Nearly 33 percent of California’s 30,000+ dentists participate in Medi-Cal Dental. With plenty of room for dentists all over the state to enroll, the benefits of joining forces with this robust program just got a whole lot better.

Recent Improvements to Medi-Cal Dental

In 2024, several exciting changes were made to the Medi-Cal Dental program, giving Medi-Cal Dental dentists access to a wider range of potential patients, enhanced pay rates, coverage for more dental services, and an expanded pool of referral resources. 

Here are some of the most notable upgrades, which can expand your patient base and boost your bottom line:

Targeted Rate Increase (TRI) is now in effect. This generous new feature boosts payment rates for specific dental services to no less than 87.5 percent of the lowest California-specific Medicare locality rate. These rate increases are good for business. 

Community Health Workers (CHW) can now provide oral-health services and get reimbursed through Medi-Cal Dental, improving access to preventive care, oral-health education, and connections to community resources for Medi-Cal members. CHW provides important, but limited, services, so patients requiring more extensive dental care will be referred out to Medi-Cal Dental dentists, giving you an outstanding referral resource and a potential pipeline for new patients.

Asset limits for Medi-Cal eligibility have been eliminated, enabling even more Californians to access Medi-Cal Dental. Unlike in previous years, eligibility no longer requires that assets like cash, bank accounts, homes, and second vehicles be considered during the application process. With fewer intimidating barriers in place for enrolling in Medi-Cal, more people will be signing up, which means a larger potential patient pool for you. 

Expanded access to dental care for children is now in place thanks to the Children’s Presumptive Eligibility (CPE) program. This enables eligible kids under 19 to access full-scope dental health care while their application for ongoing coverage is under review. Translation? More young patients walking through your door equals people who may very well become part of your practice for years to come.

Mandatory dental coverage for qualifying patients aged 26 to 49 has been enacted, regardless of their immigration status. With more people stepping out and enrolling in Medi-Cal Dental, your practice will benefit as well.

Are you in a dental specialty? Good news on that front, too. Restrictions have been pulled back on services like orthodontic reimbursement; plus, periodontists will see increased payment for procedures like scaling, root planning, and crown procedures. Better reimbursement and payment plans are not only fair, but they enable dentists to provide the best possible care for their patients’ specific and sometimes complicated dental needs.

In 2022, and in line with national dental care standards, Medi-Cal Dental added more preventive-treatment options, notably the ability for Medi-Cal Dental dentists to administer silver diamine fluoride to eligible patients under age seven, nursing-home patients, and those with intellectual and developmental disabilities. In 2024, Medi-Cal Dental launched a pay-for-performance initiative to encourage and reward dentists for providing preventive-care services. These important upgrades give California’s underserved population access to premium preventive care and can bolster revenue streams at participating dental practices.

Why Participate in Medi-Cal Dental? 

Every licensed California dentist who meets specific requirements (as mandated by the Department of Health Care Services) is invited to participate in the Medi-Cal Dental program by completing an application. Once admitted, the benefits are numerous, ranging from the practical to the altruistic.

Let’s start with the practical.

• Amplified patient base – Once your name appears in the Medi-Cal Dental database, a portion of the nearly 15 million Californians enrolled in the program will have the opportunity to become your patient. With instant visibility, you can quickly grow your practice, especially if you’re just starting. 
• Student-loan repayment – Once enrolled in Medi-Cal Dental, you may be eligible to receive student-loan-repayment assistance through the CalHealthCares program, enabling you to pay off that debt faster and start making money.
• Practice-support grants – In an effort to encourage dentists to establish, expand, or relocate their practices to underserved areas with substantial Medi-Cal populations, CalHealthCares offers practice-support grants to facilitate those moves. Launching or moving a practice is expensive, so these subsidies could be a huge financial boon.

And the altruistic? That’s clear. Medi-Cal Dental dentists have the great satisfaction of helping underserved men, women, and children who may not otherwise be able to get adequate oral health care, simply because it’s the right thing to do. And when word spreads of your good work, that burnishes your reputation and community standing and brings in more patients.

Yes, But What About Insurance Paperwork? I’m Already Drowning!

Despite recent improvements in the system, there’s no debating that Medi-Cal Dental involves some complex, highly specific claims-management acrobatics, well beyond what you may be accustomed to with standard insurance companies. If your billing team isn’t adequately trained in Medi-Cal Dental, or if you have high turnover in your billing department, you will never be able to maximize collections, be reimbursed in a timely manner, or, for that matter, get reimbursed at all. 

Don’t take chances.

Enter eAssist Dental Solutions. As the country’s leading dental-billing company, serving more than 3,000 dental practices, eAssist is ready to stand in as your remote Medi-Cal Dental billing department. That means everything comes off your plate and lands on ours. And we mean everything, from the start of a case to the finish, including:

• Sending pre-authorization paperwork to Medi-Cal Dental
• Submitting dental claims within one business day of service
• Posting insurance payments as they come in
• Actively researching claims that haven’t been paid in 30 days and taking corrective action to get them processed
• Collecting within 99 percent of what our dental clients are producing
• Assigning an eAssist point of contact, so you always have someone to reach out to with questions or concerns

In other words, you focus on what you do best, dentistry, and we’ll make sure you’re paid the highest amount in the least amount of time.

Our U.S.-based eAssist employees aren’t just “insurance people,” they’re “dental people,” too, trained in practice-management software, with knowledge of dental charts and coding, dental-billing practices, how to take and read x-rays, and more. Every member of the eAssist team must pass a test before being hired, so our staff is extremely well vetted, experienced in dentistry and billing, and highly accessible.

If you’ve been enrolled in Medi-Cal Dental and find yourself in insurance-paperwork chaos, plagued with over-90-day accounts and other issues, we can take the reins and clean everything up, putting you back on track for timely (and profitable) collections. If you’re new to Medi-Cal Dental, onboard with us now, and it will be smooth sailing from the get-go. 

For a reasonable, commission-based fee, eAssist can save your practice the hassle of trial-and-error claims submissions, wondering why you’re not getting reimbursed (if paperwork isn’t perfect, it will be rejected), and chasing dollars. Moreover, you won’t have to spend time and money training staff in the convoluted (and always evolving) Medi-Cal Dental insurance process, then risk losing those employees and having to train new people all over again. This is what we do at eAssist, and we do it well.

Ready to Let Us Do the (Insurance) Dirty Work? 

At eAssist, we’re standing by, prepared to dive in and take over your insurance and collections headaches. And because we handle everything remotely, you don’t have to change your current systems, train new personnel, or worry. Don’t wait another day to alleviate frustration and time-consuming claims-management acrobatics: Schedule a consultation with eAssist now. 

Rob Linder

Chief Strategy Officer

Rob is the Chief Strategy Officer of eAssist, where he leads business development, strategic partnerships, and service delivery across the company’s nationwide customer base. He previously served as Co-Founder and CEO of Espire Dental, a 50-location dental group recognized nationally for its exceptional patient experience and culture. Before Espire, Rob was VP of Dental Services at ClearChoice Dental Implants, the leading U.S. provider of full arch dental prosthetics with 100 ambulatory surgical centers. His earlier leadership roles include SVP of SmileAmerica, delivering dental care to underserved children across 22 states, and Co-Founder of Dental Growth Partners, supporting 17 specialty practices in New England. Rob began his career as a Business Consulting Manager at Arthur Andersen in San Francisco, where he managed audits for major healthcare and technology clients, including Catholic Healthcare West, Stanford University Health Center, Cisco Systems, Symantec, and Fujitsu. He holds an MBA from Boston University and a BS from Brigham Young University.