Medicaid:
A joint state and federal program, which pays for healthcare
services on the behalf of individuals who meet specific criteria.
Medicare: A federal health insurance program that provides
benefits to those age 65 and older or Social Security disability
benefits.
Medical
Assistance Division (MAD)
Direct administration of Medicaid Programs
Fiscal responsibility
There are two different Medicaid plans with different service
providers: Managed care organization (MCO) or Salud. These
health plans include Lovelace, Presbyterian and Molina Health
Care. The dental portion of the Medicaid program is administer
by Doral dental services
The Fee-for-Service (FFS) or Medicaid exempt, program administrator
is ACS. Inc., and oversees both the medical and dental program.
Salud programs have about 2/3 of New Mexico's Medicaid recipients
FFS programs have about 1/3 of New Mexico's Medicaid recipients
Currently in NM 1 out of 5 New Mexicans are enrolled in
Medicaid
The
mission of the medical assistance division is to assure
access to medically necessary services for Medicaid eligible
individuals
Dental
Medicaid program role is to:
Oversee the service providers who administer the dental
program.
Provide technical assistance for Medicaid FFS dental providers.
Work closely with MCO in regard to dental issues.
Review dental claims.
Handle complaints from both dental providers and Medicaid
recipients.
Support dental provider recruitment into the NM Medicaid
dental program.
Promote community outreach with dental associations.
Work on policy, benefits, services and billing for dental.
Contact
information:
Britt
Catron, RDH, MS, CHES
Dental Director
Phone: (505) 827-6246
Email: britt.catron@state.nm.us
Mailing
address:
HSD/MAD
PO Box 2348
Santa Fe NM 87504-2348
Other
important Numbers at MAD
Main phone number (505) 827-3100
Toll-Free number 1(888) 997-2583
Service providers of the dental program
Doral dental 1(800) 417-7140
ACS, Inc. 1(800) 299-7304
The service providers are available to answer questions
in regard to, billing procedures, claims status, provider
enrollment and client eligibility.