Petition from Massachusetts Dental Providers: Urgent Action Needed on BeneCare Administrative Failures

Dear MassHealth and BeneCare Leadership,

We, the undersigned Massachusetts dental providers, are deeply concerned about the ongoing administrative problems following the transition of the MassHealth Dental Program to BeneCare on April 1, 2025.

For some of us, over 70% of our patient population depends on MassHealth. We have proudly continued to serve these patients—even with lower reimbursement rates—because MassHealth administration historically operated with accuracy, accountability, and timeliness. Unfortunately, under BeneCare, that reliability has been lost.

Our Concerns

1. Lack of Transparency

Providers were not given clear reasoning as to why DentaQuest was removed. We have a right to know why this transition occurred, given its widespread consequences.

2. Eligibility Verification Failures

Eligibility—the most basic function of a dental benefits administrator—remains unreliable. Patients are confirmed as eligible at the time of service, only for claims to be denied later as “patient not eligible.” After five months, this issue remains unresolved, eroding provider trust.

3. Excessive Administrative Burden

Our staff spend an average of 45 minutes daily on hold with BeneCare.
We are limited to checking five patients per call—an impossible restriction for offices seeing 50 or more MassHealth patients daily.
Despite our efforts, many claims are still denied incorrectly, creating financial strain and diverting time away from patient care.

4. Financial Instability from Advanced Payments and Recoupments

BeneCare began issuing emergency/advanced payments to practices but quickly capped them at “maximum historical claim payments.”
Recoupments then began, despite unresolved system errors and eligibility failures.
Recently, BeneCare paused recoupments for eight weeks, but we request recoupments remain suspended until all system problems are resolved.
Current mailed remittances are far below expected claim amounts and do not reflect the care provided—while recoupments further reduce what little is paid.

5. Broken Claims & Remittance Systems

We still cannot access remittances online through the provider portal; only mailed copies are available, causing delays and inefficiencies.
Certain procedure codes are automatically denied due to ongoing system glitches. After five months, no corrective action has been communicated.

6. Patient Impact

These failures directly reduce access to care for vulnerable patients, delay necessary treatment, and risk discouraging providers from continuing to participate in MassHealth.

Our Requests

We, the undersigned providers, respectfully demand:

Transparency on why BeneCare replaced DentaQuest.
Immediate correction of eligibility verification errors, with a firm timeline for resolution.
Removal of the “five-patient per call” limit and creation of a reliable, real-time eligibility system.
Reprocessing of all incorrectly denied claims and restoration of lost payments.
Suspension of recoupments until BeneCare demonstrates full system stability and accuracy.
Online access to remittances through the provider portal, as promised.
Correction of systemic coding errors that cause unjustified automatic denials.
Accountability for BeneCare’s performance—and if they are unable to resolve these issues promptly, we request that MassHealth seek a more capable administrator.

We have always been committed to serving MassHealth patients. But the current administrative failures jeopardize our ability to continue. MassHealth members deserve better, and so do the providers who care for them.

Respectfully,