Elements of Distinction

How is Advantica different than other dental management companies?

We believe we are different than other dental management companies in a variety of ways. We don't play games with administrative fees and hidden costs. Our administrative fees are upfront and reported.

We help you improve the quality of your Medicaid dental program through stronger partnerships. We can even set up staff model clinics to support your program while dramatically cutting hospitalization rates and reducing costs.

We provide you with services that will ensure your compliance with Medicaid rules and reports. We offer you extensive experience in pediatric dentistry-in fact, our founder is a pediatric dentist. And since 9 out of 10 Medicaid patients are children; that's a distinct benefit.

We promote preventive care and member education-an essential way to help keep costs down.

What is Advantica's philosophy to providing care?

At Advantica our philosophy is that better dental care is provided through better partnerships with HMOs, dentists, members and State entities. A partnership with Advantica empowers our clients by rising above the challenges of today's Medicaid environment.

At Advantica, quality is a never-ending journey. As a partner with Advantica, we help facilitate enhanced quality in management and patient care through constructive dialogue, expertise in the field, and true innovation.

And, when you partner with us to manage your Medicaid dental benefits, our team spends the time and effort it takes to get to know the details and nuances of your specific and unique requirements. Our partners include our contracted health plans, their members and our participating providers-as well as the gubernatorial entities who monitor the managed care programs with which we participate.

We listen to you one-on-one, then our team responds with a clearly defined, customized program that includes a broad sweep of services-all designed to help you succeed in the Medicaid environment.

You can trust Advantica to take care of your Medicaid requirements. Our approach to administering Medicaid benefits is honest, straightforward and accountable. This frees you up to focus on the medical side of business and provide quality dental services. That's the biggest reason why we believe the Advantica difference really shines through.

Finding dentists to provide for Medicaid recipients is so hard. How do you improve on the network of dentists providing care?

At Advantica we believe that every region is unique so we don't apply the same network development approach to every market. We distinguish ourselves by having the ability to develop network of dentists that can include independent providers as well as dental and specialty staff model centers dedicated exclusively to the Medicaid program. These centers are key in providing access and controlling costs.

How does Advantica retain dentists in its programs?

By partnering with our providers and making sure that they understand the important role they play in the delivery of dental care. This is why we take the time and put forth the effort to develop Advisory Boards in every market we service. This ensures our clinical and operational policies and procedures are in tune with the practice patterns of the community that we serve and it makes our policies easier to implement. Our providers and clients also know that we do not play games with the premium by adding "other" administrative fees. We treat our providers with the same respect, honesty and integrity that we treat our clients and our members. This approach gives us more satisfied providers.

Dentists FAQs

How will I be reimbursed?

Dentists are reimbursed on a fee for service basis using a global budget methodology, which takes into account the membership's utilization. Payment is based on a premium or discount of a set fee schedule.

Will I have the same administrative difficulties as I do with Medicaid?

No. Our programs are simplified to make it easy for provider participation. For example, you don't have to use Medicaid made up codes; and you can perform claim submissions and prior authorizations electronically.

Will I have any input on how the program is administered?

Absolutely! Our programs are managed by an Advisory Board made up of local dentists. The Advisory Board helps us determine the clinical and administrative policies our company implements.

Can I limit the amount of patients I accept in my practice at a given time?

Yes. A dentist can determine that he/she can only accept a certain amount of HW patients at any given time as long as they do not discriminate against low income patients.

How can I get more information on the program?

To get more information on our company or the programs we administer, please call us toll free at 1-866-354-2020, or write us at the following address: Advantica, 12399 Gravois Road, Second Floor, St. Louis, MO 63127.