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Jan 12 2023
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]
Jan 12 2023
The Ohio Department of Medicaid (ODM) is asking all dental providers enrolled in Medicaid to complete a survey regarding the services they provide to Medicaid members. The purpose of the survey is for ODM to ensure that adequate dental coverage exists for Medicaid members. To take the survey, visit ... [continue reading]
Jan 12 2023
On Feb. 1, 2023, Ohio Medicaid’s seven Next Generation managed care plans will begin serving members. At the same time, ODM’s new Electronic Data Interchange (EDI) and the Fiscal Intermediary (FI) will go live. For more details about the launch, including training resources for providers, visit ... [continue reading]
Jan 12 2023
In 2023, the Ohio General Assembly will consider and pass the state budget for fiscal years 2024 and 2025. The ODA’s biggest priority for the next state budget will be to significantly increase funding for the state’s dental Medicaid program. The ODA has already begun the process of educating policymakers on the importance of fully funding ... [continue reading]
Jan 12 2023
The federal No Surprises Act and Ohio’s surprise billing law have been in effect for a little over a year. While it appears there may be some limited confusion about the laws and their application to the average dentist, it also appears that this confusion has not resulted in Ohio dentists incurring substantive negative consequences from either ... [continue reading]
Dec 13 2022
Question: Can a dentist who is not under contract to an insurance company be forced to accept the insurer’s allowed fee solely because the dentist accepted assignment of benefits from the patient? Answer: Providing nothing else is going on, no. Just as a patient/subscriber and a dentist cannot obligate an insurance company or other ... [continue reading]
Nov 11 2022
The Next Generation of the Ohio Medicaid program went live on Oct. 1. Effective Oct. 1 all provider enrollment applications must be submitted using Ohio Medicaid’s new Provider Network Management (PNM) module. The PNM module is the single point for providers to complete provider enrollment, centralized credentialing and provider ... [continue reading]
Nov 11 2022
SDC and the MMO SuperDental MA Network The Ohio Dental Association has received a number of calls from ODA member dentists concerning a letter they received from Superior Dental Care. The letter informed SDC contracting dentists of a material change SDC was making to its participating provider network to include them as contracted providers in ... [continue reading]
Oct 17 2022
The Next Generation of the Ohio Medicaid program went live on Oct. 1. Effective Oct. 1 all provider enrollment applications must be submitted using Ohio Medicaid’s new Provider Network Management (PNM) module. The PNM module is the single point for providers to complete provider enrollment, centralized credentialing and provider ... [continue reading]
Oct 17 2022
Based on dentists’ reports to the Ohio Dental Association, a small number of insurance companies and third-party administrators (TPAs) began issuing reimbursement to dentists via virtual stored value credit or debit cards instead of paper checks over a decade ago. While the number of third-party payers that use this payment methodology still ... [continue reading]
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