Category: Dental Insurance & Medicaid

The Ohio Dental Association recently launched a new webpage on www.oda.org with resources on Medicaid and Medicare. Resources include: Information about incorporating Medicaid into a dental practice. A webinar created by the ODA with practical steps on how to successfully incorporate Medicaid into an Ohio dental practice. Information ... [continue reading]

Ohio’s Medicaid program provides publicly funded health care coverage to about 3 million low-income Ohioans (or about 26% of the state’s population), including children, pregnant women, older adults, people with disabilities and other adults. It is jointly funded by a roughly 65-35 split of federal to state tax dollars for most Medicaid ... [continue reading]

The most common concern that Ohio Dental Association member dentists have presented to the ODA’s Dental Insurance Working Group over the past many months has involved multiple dental insurance companies denying or deeming scaling and root planing claims not billable to the patient (i.e., the claim is denied and the dentist is contractually ... [continue reading]

Happy March! I am excited about seeing everyone at Leadership Institute March 21-22! If you haven’t registered yet go to https://www.oda.org/events-ce/leadership-institute. In this month’s column I would like to share some thoughts about Medicaid. Here are a few statistics to chew on as we go along: The population of Ohio is 11.8 ... [continue reading]

The Ohio Dental Association is often contacted by ODA member dentists upset with how an insurance company or other third-party payer has handled a dental claim. Some of these calls involve claim or prior authorization denials issued by a Medicaid HMO because the insurer determined the service in question was not medically necessary. As more ... [continue reading]

The Ohio Dental Association and LIBERTY Dental Plan have successfully worked together to develop practical plan criteria and medical necessity guidelines that dentists and LIBERTY can use to demonstrate the actual placement of a crown during the claim submission process for LIBERTY’s Medicare Advantage Plan. LIBERTY reported that it has ... [continue reading]

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]