Category: Dental Insurance & Medicaid

Deciding to join/not join an insurance company’s dental network can be influenced by numerous factors (e.g., the place where the dentist is in their career; whether or not the dentist is an employer, employee or independent contractor; marketplace standing of the dental insurance company; value that the network brings to the dentist; etc.) and ... [continue reading]

Since the state of Ohio dramatically increased the reimbursement rates for Medicaid dental services, the Ohio Dental Association has received and continues to field many calls from ODA member dentists interested in learning more about the Medicaid program. It is not surprising that the fee increase has garnered so much attention. Low ... [continue reading]

The American Dental Association has released the CDT 2026, which took effect Jan. 1, 2026. The new CDT 2026 is the HIPAA-recognized code set for dentistry. The CDT 2026 features 31 new codes, 14 revisions, and covers saliva testing, prosthetics, implant maintenance, photobiomodulation, anesthesia, and more. The ADA offers several CDT coding ... [continue reading]

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]