Category: Dental Insurance & Medicaid

If you have been unsuccessful in resolving a dental insurance or third-party payer situation, you may want to consider submitting information to the Ohio Dental Association’s Dental Insurance Working Group (DIWG) to determine if the ODA has a role in addressing the matter. The DIWG is comprised of a dedicated group of ODA member dentists who ... [continue reading]

The Ohio Dental Association has received many calls over the last number of months concerning Ohio’s new non-covered services law. It may be helpful to review the new law and the commonly asked questions concerning it so dental offices have a good idea of what to expect from its full implementation on Jan. 1, 2025. Background and key to ... [continue reading]

One of the more common calls to the Ohio Dental Association involves the proper way to report dental insurance claims when the treating dentist is different from the billing entity or billing dentist. Most of the calls were prompted by a dental practice bringing on an associate for the first time though some involve dentists who are going on ... [continue reading]

A new report from the American Dental Association’s Health Policy Institute shows the dramatic improvement state policymakers have made to the Ohio dental Medicaid program. Ohio’s dental Medicaid reimbursements have gone from near the bottom in the country to near the top as a result of a significant increase in funding starting earlier this ... [continue reading]

It has been estimated that synthetic identity fraud, the creation of new identities with stolen or fabricated data, is the fastest-growing financial crime in the United States. In fact, the U.S. Department of Justice, Bureau of Justice Statistics has reported “in 2021, about 23.9 million U.S. residents age 16 or older (9% of the population) had ... [continue reading]

The Ohio Department of Medicaid has responded to the Ohio Dental Association’s formal request for ODM to standardize the administration of state’s Medicaid dental benefit program across the fee-for-service and managed care programs. The ODA’s request was prompted by ongoing concerns many ODA members have expressed with how DentaQuest ... [continue reading]

On July 24, 2024, Gov. Mike DeWine signed Senate Bill 40, which contained language that would eliminate the requirement for dentists to accept a fee schedule for services that the insurance companies do not even cover. This was the result of many years of advocacy from the ODA on the topic. But now that it has passed what does this mean for dental ... [continue reading]

The Ohio Dental Association continues to monitor and address numerous third-party payer issues on the ODA membership’s behalf. One issue of particular note that the ODA monitors involves silent discount arrangements, which are commonly known as “silent PPOs,” “ghost PPOs” or “blind PPOs.” The American Association of Preferred ... [continue reading]

Gov. Mike DeWine signed Senate Bill 40 into law on July 24. This important legislation prohibits dental insurance companies from setting fees for non-covered services and improves professional practice portability by entering into the Dentist and Dental Hygienist Licensure ... [continue reading]

Even though the new version of the American Dental Association’s Current Dental Terminology (CDT) will not take effect until Jan. 1, 2025, Ohio Dental Association member dentists interested in seeing changes made to the CDT should be thinking about submitting their revision suggestions now. The CDT’s purpose is “to achieve uniformity, ... [continue reading]