Category: Dental Insurance & Medicaid

When it comes to managed care contracting issues, one of the more common calls the Ohio Dental Association receives involve leased dental networks. Callers’ questions typically are something like: How can I be bound to a plan’s fee limits when I never signed a contract with that plan? Can I stay in the network but opt out of one or two ... [continue reading]

The Ohio Dental Association Council on Dental Care Programs and Dental Practice continues to monitor and address third-party payer issues on the ODA membership’s behalf. One issue of particular note that the council has been monitoring involves silent discount arrangements that are commonly known as “silent PPOs,” “ghost PPOs” or ... [continue reading]

Effective May 1, 2020, CareSource transitioned the administration of the dental component of its Medicaid HMO product to DentaQuest. A number of issues have emerged as a result of this transition. Representatives of DentaQuest and the Ohio Dental Association, through the ODA Medicaid Working Group, have been working together to identify and then ... [continue reading]

Like with almost everything else, 2020 was a challenging year for dentists and dental offices when it came to dental insurance and third-party payment issues. While nothing seemed to come easy, the volunteer member dentists who served on the ODA Dental Insurance Working Group and the ODA as a whole took an active role in assisting the membership ... [continue reading]

The Ohio Dental Association has written Aetna Dental PPO to express its concerns with a recent decision by Aetna 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 Aetna Dental PPO that it would be utilizing a new fee ... [continue reading]

The end of this year will mark the end of the 133rd General Assembly. That means all pieces of legislation pending before the Ohio legislature that have not been adopted into law will be discarded. If these legislative proposals are eventually to become law they must then be re-introduced and begin the legislative process all over again in the ... [continue reading]

More attention is being given to dentists having a separate charge for personal protective equipment (PPE) or infection control from a variety of sources, many of which are not keen about the idea of dentists levying this charge on their patients. Those weighing in on the idea range from dentists to patients to insurance companies to state ... [continue reading]

The Ohio Dental Association's Medicaid Working Group has acted upon and continues to address a number of matters relative to Ohio's Medicaid dental program. Rebidding Ohio’s Medicaid HMO contracts Early last year Gov. Mike DeWine called on the Ohio Department of Medicaid (ODM) to rebid the state of Ohio’s contracts with the private ... [continue reading]

The COVID-19 pandemic has caused much disruption throughout every facet of society. An impact it has had on dentistry has directly led to increased costs for dentists to provide care while at the same time significantly decreasing dentists' ability to recover those costs via the number of patients they may see in any given period of time. While ... [continue reading]

  Even before Ohio dentists were permitted to re-open their dental offices to provide more than just emergency only dental care, there was much discussion about the increased costs that dentists would incur in order to provide dental care in the current and post COVID-19 era. These discussions have involved not only increased costs but also ... [continue reading]