How is Doral Dental doing with MassHealth members?

The dental benefit through MassHealth/Doral is worthless in my opinion. What's the purpose of having a benefit if I can't use it?

The problem:

Most dentists don't accept it MassHealth.

Most of the dentists who do accept MassHealth will only treat members who are under 21.

Most of the dentists who see adult MassHealth members aren't accepting new patients.

Most of the dentists who are accepting new adult MassHealth members are scheduling 6 months to a year out and won't provide urgent care unless you are an established patient.

I called all the dentists in my town, in neighboring towns, and in all the towns within a 30 mile radius. When I was unable to find a dentist on my own, I called Doral. I spoke with a very nice, sympathetic woman who truly wanted to help me---unfortunately, the only she could do was call dentists on the MassHealth/Doral list... the same MassHealth/Doral list that I had. She called the same dentists I called and not surprisingly, got the same answers I did.

She did eventually find me a dentist... I only had to wait 3 months. It took me 45 minutes to get there, and once there, I discovered that his office was on the 2nd floor of a building with no elevator... a big problem for someone who uses a wheelchair. The MassHealth/Doral list said that his practice was "Handicap Accessible." Stupid me---I thought that meant that disabled people would be able to access the building. Three months wasted.

The dentists I've seen through MassHealth/Doral--three of them now--were horrible. One made inappropriate comments about my gender and presumed sexuality, and then followed it up by telling me I was lazy and needed to get a job. Another had a really dirty office in a dilapidated building... and didn't wash his hands between patients. My favorite, however, was the dentist who refused to use anesthetic to numb my mouth when he drilled/filled my tooth. I told him to stop and when he didn't, tried to pull my head away... he and his assistant responded by pushing my head against the chair so I couldn't move and continued to drill.

I have a number of cavities left and visible decay. My teeth are rotting and there's nothing I can do about it. My teeth hurt most of the time and I'm embarrassed to smile. I'm afraid that by the time I get to a dentist, my teeth will be so bad they're beyond fillings--I'll need root canals and other extensive dental work. MassHealth only covers fillings and extractions. If things don't change--and fast--I'm going to end up with dentures at age 30.

Wonderful.

As a MassHealth consumer, my two experiences with DORAL's prior-authorization for dental services have been a truly hideous, nightmare experience. DORAL took months to make a decision on excruciating dental pain and denied both cases, which caused MONTHS of prolonged suffering and agony while awaiting approval for necessary (and supposedly covered) treatment, only to be denied coverage. To be specific: two front teeth needed root canal service at two separate times/submissions. Both requests were sent with all proper documentation and radiographs showing the vast infection and decay into the nerve root/canal areas of both teeth. The first root canal request was denied stating the tooth was a lost cause. WRONG! After suffering excruciating pain for months and calling DORAL weekly, at times every other day stating I was sobbing, up nights in horrendous pain, and calling on the Name of the LORD in agony, I went through prolonged weeks of suffering only to pay for the root canal out of pocket on a payment plan with a private dentist, and the tooth is still in my head, the prognosis from DORAL was incorrect! I asked DORAL to reimburse this incorrect decision and denial of service and the said nothing could be done.
The second front tooth root canal request came back after months of sleepless nights and suffering as not necessary. Truly I would like to know, between the extremes of "lost cause" and "unnecessary" does ANYBODY out there ever qualify for an actual root canal? Unnecessary? I seriously considered committing suicide during those prolonged weeks of hideous pain and suffering awaiting two improper DORAL decisions and I honest to God wish the state would tell Masshealth consumers and tax payers the truth: there is no dental coverage for physically disabled Social Security recipients as PR advertised, rather these funds are going into the managed care system of DORAL itself rather than as services to the consumers.

DORAL is in my opinion a hideous shame. I am a physically disabled person who has refused pain management and even takes my outpatient surgeries with NO anesthesia, no twilight sleep IV's -- and because of DORAL my pharmacist watched me BEG my primary care physican for two days worth of narcotic pain relievers at a time for months, TWICE, for a condition that seriously wanted to make me put my head in a drawer and slam it. I would like to know how the dental director of DORAL lives with himself/herself, I'm sure they have great dental coverage as part of their benefits package. Well, sir or madam, in the karma of life, one day you too may find yourself at the end of a bread line begging for mercy, and if or when you do, remember all the people you left in hideous pain with your wrongful handling of prolonged denials that you misdiagnosed. I would have rather been told the truth: managed care funds are spent on the administration of the managed care, not for the good of the health/dental needs of the consumer. This truth would have saved me literal MONTHS of prolonged agony in anguish with pain and suffering HOPING on an approval for a serious infection that eventually became systemic while waiting only to be WRONGLY denied both times. I have spent approximately 1400 dollars out of pocket to avoid the disgrace of having holes in the front of my face; I have already lost my back teeth since there is no coverage for root canal services on back or side teeth, but how DARE DORAL get consumers' hopes up and cause them months of agony waiting, hoping, that the infection that is now blowing out their eye socket and swelling up the side of the face and even seen on sinus CAT scans as DENTAL infection might be considered coverage worthy when it's supposedly a covered benefit to begin with. Seriously, for shame. I hope somebody with the power and resources sets this system right and spares people of this kind of humility and anguish.

There is probably more access to care, as more providers have enrolled to take MassH patients.
Doral has made it more difficult to get dental specialty services, especially for gum treatment but also for denture replacement.
The WORST area, though, is that they have lost prior approvals that I have sent in, along with the patients xrays (6 this year). That means the patients services are delayed, or not gotten, and we have to take new xrays at no charge, to resubmit.