Category: Dental Insurance & Medicaid

Receiving a clear, concise explanation of the terms of a provider contract may help you decide if participating with such a plan is best for you and your patients, as well as helping you avoid unpleasant surprises under the contract in the future. The ADA Contract Analysis Service will provide you with information concerning a proposed contract ... [continue reading]

The Ohio Dental Association has called upon the Ohio Department of Medicaid to standardize the administration of the state’s Medicaid dental benefit program across the fee-for-service and managed care programs. The ODA’s move is in response to ongoing concerns many ODA members have expressed with how DentaQuest administers the dental benefit ... [continue reading]

New Ohio dental Medicaid fees went into effect on Jan. 1. The new fees come to an average of a 93% increase over the previous fees, which had not seen any significant increase in over 20 years. “The new reimbursement rates are having a positive effect across the board,” said Dr. Jennifer Kale, chair of the ODA Medicaid Working Group. “Many ... [continue reading]

“You win with people.” – Woody Hayes While Woody Hayes’ famous quote is often associated with football, it is also very applicable to other sports, business and most other endeavors, including the world of dental insurance and third-party payment. It applies to dental insurance when you consider that no matter how accurate, diligent and ... [continue reading]

Let’s all be clear about the 93% fee increase that started Jan. 1, 2024 for Ohio dental Medicaid. It would never have happened without the efforts of the Ohio Dental Association. Individual dentists in the state could not have done it. Small group practices would have failed and certainly, large DSOs could not have gotten this fee increase ... [continue reading]

Dental insurance is often instrumental in getting patients into a dental office because it assists them in paying for dental services they may otherwise not obtain. Dental insurance is also, unfortunately, a source of aggravation and frustration for dentists when certain claims for dental services are handled in a way that is disagreeable to the ... [continue reading]

Based on calls the Ohio Dental Association is receiving from ODA member dental offices, it appears that some patients are attempting to lower their financial obligations to their dentist by citing the No Surprises Act. In each instance, however, the patient’s contention that the dentist had to waive some of their outstanding balance because of ... [continue reading]

Last month, I wrote my column on the ODA membership survey conducted in the fall of 2023. To review, we commission an independent survey research firm to conduct a broad, comprehensive survey of the entire ODA membership periodically. We did such surveys in 1988, 1991, 1994, 1998, 2002, 2007, 2012, 2018 and again in 2023. While the surveys have ... [continue reading]

Early in the year, the Ohio Dental Association and Ohio Academy of Pediatric Dentistry penned a joint letter to Maureen Corcoran, Director of the Ohio Department of Medicaid, concerning coding practices and reimbursement levels for dental treatment that must be provided in hospital or ambulatory surgical center operating room settings for patients ... [continue reading]

For many dentists, terminating a participating provider agreement with a preferred provider organization (PPO), dental health maintenance organization (DHMO) or other type of third-party payer can be a nerve-wracking experience, largely attributable to a fear of losing patients who are covered by the plan the dentist is terminating with. If these ... [continue reading]