News Filters

122 posts found

Jan 11 2022
The November and December Dental Insurance Corners discussed a letter that was recently sent from a major dental insurer to numerous Ohio dentists concerning their practices’ utilization patterns, how utilization review works and what dentists can do to minimize their risks with respect to third-party payer reviews and audits. There are steps ... [continue reading]
Jan 11 2022
The ADA Council on Dental Benefits Programs is proceeding with a new project to review and enhance the Code on Dental Procedures and Nomenclature (CDT Code). As part of the project, the Enhanced CDT Taskforce is seeking comment from dentists. Dentists can provide feedback via email to dentalcode@ada.org by January 14, 2022. Dentists may also ... [continue reading]
Dec 14 2021
Last month’s Dental Insurance Corner discussed a letter that was recently sent from a major dental insurer to numerous Ohio dentists concerning their practices’ utilization patterns. Insurance companies utilize auto-adjudication to process more claims than ever. Auto-adjudication is the automated process of paying or denying claims quickly ... [continue reading]
Nov 9 2021
A letter recently sent from a major dental insurer to numerous Ohio dentists concerning their practices’ utilization patterns has prompted calls and questions to the Ohio Dental Association. The callers expressed confusion and concern about the letter and questioned what it really meant to their practices and what actions they should take in ... [continue reading]
Oct 19 2021
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]
Sep 9 2021
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]
Aug 11 2021
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]
Jul 12 2021
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]
Jul 12 2021
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]
Jun 21 2021
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]
The views expressed in the articles and columns on oda.org are solely those of the author(s) and do not necessarily represent the view of the Ohio Dental Association (ODA). The columns are intended to offer opinions, information and general guidance and should not be construed as legal advice or as an endorsement by the ODA. Further, information posted on oda.org is not an endorsement by the ODA and should be viewed on an informational basis by users of the website. Dentists should always seek the advice of their own legal counsel regarding specific circumstances.