Category: Dental Insurance & Medicaid

The Ohio Dental Association has written Cigna Dental to express its concerns with a recent decision by Cigna to substantially reduce network dentists’ reimbursement. The ODA’s action is in response to a number of ODA member dentists who contacted the ODA after receiving a letter from Cigna Dental that it would begin utilizing a new fee ... [continue reading]

While there is a clear trend for dentists to join into participating provider agreements with managed care plans now more than ever, the Ohio Dental Association has received a marked increase in the number of member dentists inquiring about how to terminate their contracts with networks they participate in. Some of the callers were just starting ... [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 many claims. Slow ... [continue reading]

One of the busiest times of the year has come and gone in the Ohio legislature. The biennial operating budget (House Bill 110) has passed the House and Senate and has been signed by the governor. The budget has to be passed by July 1 in order for the state to continue to operate. The main purpose of the budget is to allocate money to departments ... [continue reading]

On May 19, 2021, Ohio Medicaid vendor Maximus learned of a cybersecurity incident involving an application related to Medicaid providers’ credentialing and licensing data in Ohio, according to the Ohio Department of Medicaid. The incident potentially impacted some personal information about Medicaid providers (such as names, dates of birth, ... [continue reading]

The Ohio Dental Association has presented a written request to Delta Dental of Michigan, Ohio, and Indiana that calls for Delta Dental to take immediate steps to address its reimbursement rates by 1) increasing dental reimbursement rates and 2) incorporating an annual cost of living increase to its reimbursement practices. The letter is a ... [continue reading]

If you have been unsuccessful in resolving a 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 volunteer their time ... [continue reading]

Every month, a dedicated group of Ohio Dental Association member dentists volunteer their time to serve during conference call meetings of the ODA Dental Insurance Working Group (DIWG). They address the wide variety of dental insurance related questions, concerns and complaints that are submitted by ODA member dentists seeking help on matters they ... [continue reading]

In early April the Ohio Department of Medicaid (ODM) announced which insurance companies it has preliminarily selected to administer the $20 billion managed care or Medicaid HMO portion of Ohio’s Medicaid program. They are AmeriHealth Caritas Ohio, Inc.; Anthem Blue Cross and Blue Shield; CareSource Ohio, Inc.; Humana Health Plan of Ohio, ... [continue reading]

Within the last two years, DentaQuest has garnered a lot of attention from Ohio dentists as it began administering the dental component of CareSource’s Medicaid HMO product and through its acquisition of the private insurance company Dental Care Plus Group (DCPG). Representatives of the Ohio Dental Association, through the ODA Medicaid ... [continue reading]