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  • Actions of third-party credentialing organization raise concerns

    by Christopher Moore, MA - ODA Director of Dental Services
    9/1/2016
    ODA Today

    In 2008, the Ohio General Assembly passed the Healthcare Simplification Act. One provision of this law, Ohio Revised Code 3963.05, required the Ohio Department of Insurance (ODI) to prescribe the Council for Affordable Quality Healthcare (CAQH) credentialing application form in electronic or paper format for physicians.

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  • Dentists concerned about dental insurance companies' response to prescription drug rule; ODA to meet with major carrier on the issue

    by Christopher Moore, MA - ODA Director of Dental Services
    8/9/2016
    ODA Today

    Many dentists have contacted the Ohio Dental Association with questions and concerns about recent mailings from some dental insurance companies concerning the insurers' response to the Center for Medicare and Medicaid Services (CMS) prescription drug rule.

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  • PPO audit finding questioned

    by Christopher Moore, MA - ODA Director of Dental Services
    7/12/2016
    ODA Today

    It is not uncommon for dental insurance companies to audit and/or subject contracting and, at times, non-contracting dentists to audit and/or utilization review procedures.

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  • CMS delays enforcement of prescription drug rule again

    by Christopher Moore, MA - ODA Director of Dental Services
    5/9/2016
    ODA Today

    The Centers for Medicare and Medicaid Services (CMS) has again delayed enforcement of its new prescription drug rule to Feb. 1, 2017.

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  • Considerations for coding preventive and perio procedures

    by Christopher Moore, MA - ODA Director of Dental Services
    4/15/2016
    ODA Today

    The Ohio Dental Association has received a number calls recently from dental practices asking about the appropriate use of the adult prophylaxis (D1110), child prophylaxis (D1120) and periodontal maintenance (D4910) codes.

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  • New CMS rule governing reporting and returning of overpayments

    by Christopher Moore, MA - ODA Director of Dental Services
    3/17/2016
    ODA Today

    In early February the Centers for Medicare and Medicaid Services (CMS) published its final rule addressing the reporting and returning of overpayments by Medicare providers and suppliers.

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  • Fax verification raises questions from Ohio dentists

    by Christopher Moore, MA - ODA Director of Dental Services
    2/2/2016
    ODA Today

    The Ohio Dental Association has recently received a number of calls from ODA member dentists who received a fax from a nationwide information management company requesting information specific to their practice.

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  • Dentists encouraged to report improper silent PPO actions

    by Christopher Moore, MA - ODA Director of Dental Services
    1/13/2016
    ODA Today

    The Ohio Dental Association Council on Dental Care Programs and Dental Practice monitors and addresses third-party payer issues on the profession's behalf. One issue of particular note that the council has been monitoring involves silent preferred provider organizations (PPOs).

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  • New Medicaid rules effective Jan. 1, 2016

    by Christopher A. Moore, MA - ODA Director of Dental Services
    12/11/2015
    ODA Today

    The state's largest dental benefits program, Ohio Medicaid, is implementing new rules effective Jan. 1, 2016. The wide-ranging rules impact coverage and payment policies for dental services and related oral health services.

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  • End of the year dental insurance to do list

    by Christopher A. Moore, MA - ODA Director of Dental Services
    11/10/2015
    ODA Today

    With the end of the year fast approaching, dentists should ensure their practice has acted on two third-party payer related issues before the New Year rings in.

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The views expressed in the monthly columns of the “ODA Today” are solely those of the author(s) and do not necessarily represent the view of the Ohio Dental Association (ODA). The columns are intended to offer opinions, information and general guidance and should not be construed as legal advice or as an endorsement by the ODA. Dentists should always seek the advice of their own legal counsel regarding specific circumstances.