Category: Dental Insurance & Medicaid

The dentists who volunteer on the Ohio Dental Association’s Dental Insurance Working Group meet every month to help individual ODA members who encounter dental insurance problems they are unable to resolve on their own. “In addressing individual dentists’ submissions to our working group, we have identified numerous instances where ... [continue reading]

One of the more common calls the Ohio Dental Association receives from member dentists involves the coordination of benefits (or possible issuance of refunds) for patients who are covered by multiple dental benefit plans. If such questions areis in your practice, save the two charts below as a reference on coordination of benefits. Ohio Revised ... [continue reading]

Effective Jan. 1, 2025, Liberty Dental Plan changed its requirements relative to crowns and required that all crowns for patients covered by Liberty’s Medicare Advantage dental plan be prior approved. Failure to do so resulted in Liberty denying the crown and contractually prohibiting in network dentists from billing the patient who received the ... [continue reading]

Effective Jan. 1, 2025, Liberty Dental Plan changed its requirements relative to crowns and required that all crowns for patients covered by Liberty’s Medicare Advantage dental plan be prior approved. It further stipulated that crowns not prior approved would be denied and Liberty network dentists would be contractually prohibited from billing ... [continue reading]

Imagine this: You’re a dentist with a few open slots in your weekly schedule. You’ve got the staff, the space, and the skills — but those chairs aren’t always full. What if filling just two to six of those slots each week could bring in an extra $50,000 to $110,000 a year? That’s not a hypothetical. It’s happening right now in ... [continue reading]

On occasion, the Ohio Dental Association receives calls from member dentists who provide dental care to their employees as an employee benefit and have questions regarding the proper way to bill for their services if the employee also happens to have a dental benefit through another source, like a spouse. Regulatory considerations It is legal ... [continue reading]

The Ohio Dental Association features many resources to help members navigate Medicaid and Medicare. Institutional credibility of the ODA with Medicaid, coupled with individual personal relationships between the ODA volunteer dentists and ODA staff with individual policymakers and decisionmakers within the Ohio Department of Medicaid (ODM), ... [continue reading]

The Ohio Department of Health recently released the results of its “Oral Health Screening Survey of Third Grade Schoolchildren in Ohio, 2023-2024.” The results of the screening survey were similar to the most recent previous survey from 2017-18. For example, the 2023-24 survey showed that 51% of the screened children have a history of tooth ... [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]

Over the years the number of calls to the Ohio Dental Association concerning prompt pay issues have dropped dramatically. Dentists’ adoption of electronic claims submission technology and insurance companies’ utilization of automatic claims processing practices have significantly helped with the timely adjudication of claims. Problems ... [continue reading]