Leveraging its unparalleled expertise and experience working with Medicaid dental programs, management of the Maryland Health Smiles Dental Program (Maryland Healthy Smiles) has been successfully transitioned to Scion Dental, part of the SKYGEN USAfamily of distinguished benefit management companies. Scion Dental now managesdental benefits for the roughly 650,000 Medicaid members in the program under a contract awarded by the State of Maryland’s Department of Health and Mental Hygiene (DHMH).
The successful transition continues the rapid growth trajectory of both Scion Dental and SKYGEN USA in 2016. Overall in the U.S., Scion Dental now manages benefits for more than 10 million covered lives across Medicaid, Medicare and commercial payer programs in more than 65 markets.
Scion Dental has been aggressively expanding its footprint in dental benefit management since its ownership emerged from a five-year non-compete agreement following the sale of a previous company that focused exclusively on managing Medicaid dental benefits. This initial state contract creates an additional proof point for other Medicaid dental carve-out states looking to improve the performance and functionality of their programs. Maryland is one of 13 carve-out states for dental, which means Scion Dental is working directly with the state, rather than through managed care organizations, to help address some of the challenges that come along with administering Medicaid dental programs.
One of three dental benefit management organizations originally competing for the contract, Scion Dental was selected as a result of having both the highest technical scores and the lowest bid. DHMH’s decision to award the contract to Scion Dental was approved by a unanimous vote of the Maryland Board of Public Works, which consists of the governor, state treasurer and state comptroller.
The wisdom of the decision was confirmed in June when the Secretary of the Department of Health and Mental Hygiene presented the 2016 Team Innovation Award to those at DHMH who were responsible for selecting and successfully transitioning the Maryland Healthy Smiles program to Scion Dental.
Technology drives excellence
Key to the high technical marks for Scion Dental is its use of the Enterprise System offered by its sister company Wonderbox Technologies. The software delivers industry-leading functionality, especially in the area of provider and member self-service web portals. These portals have allowed DHMH to offer new tools, and a remarkably user-friendly experience, to both its members and its providers.
The new provider portal has also reduced the administrative burdens on dentists and their office staff. Among its many capabilities, the portal enables providers to confirm member eligibility in an instant, confirm that services will be paid before they are performed, review applicable clinical guidelines, and submit authorization requests electronically (receiving answers within hours instead of days or weeks).
The member portal gives users the ability to instantly find dentists, check their eligibility for services, obtain answers to questions, and perform other tasks online, at their convenience, from any computer or mobile device. Both the member and provider portals are available from the State of Maryland’s website, further simplifying their use.
The awarding of the contract also brought new jobs to the State of Maryland. Scion Dental’s Maryland office is home to its contract director, dental director and other support staff. In addition, Scion Dental has built a call center team that is dedicated to serving the Healthy Smiles program through a contract with a local minority-owned business.
“Managing Medicaid benefits is very different from managing commercial benefits,” said John Schaak, president of Scion Dental. “It requires a very specific level of knowledge and a very particular set of skills. We were confident that with our team’s extensive experience in managing Medicaid benefits, and the unique technology solutions we bring to the table, we would deliver the highest quality experience for members and providers, while also helping the State of Maryland reduce its administrative costs. We congratulate the Department of Health and Mental Hygiene on earning the 2016 Team Innovation Award for our work together, and look forward to continuing to ensure the program’s members receive the quality care they deserve.”