For many dentists, terminating a participating provider agreement with a preferred provider organization (PPO), dental health maintenance organization (DHMO) or other type of third-party payer can be a nerve-wracking experience, largely attributable to a fear of losing patients who are covered by the plan the dentist is terminating with.
If these ... [continue reading]
The American Dental Association has released the CDT 2024, which took effect Jan. 1, 2024. The new CDT 2024 is the HIPAA-recognized code set for dentistry. The ADA offers several CDT coding products, including books, training tools and an app, which can be found at ... [continue reading]
The new Ohio Medicad Fees are now finalized and effective January 1, 2024. They represent the culmination of a significant amount of work performed by grassroots Ohio Dental Association member dentists, the ODA lobbying team, Ohio Department of Medicaid (ODM), Gov. Mike DeWine, the Ohio General Assembly and other oral health care advocates. The ... [continue reading]
Before I was ever in leadership with organized dentistry, before I was a dentist, and before I even knew what my life’s work would look like, I was part of a community – a group of individuals existing together through residential, familial and relational proximity. They were there when I was born; they were in my school and in my church.
No ... [continue reading]
The number of people covered by Medicare Advantage Plans in the U.S. has increased significantly in recent years. In fact, enrollment in publicly funded dental benefit plans, namely Medicaid and Medicare Advantage Plans, represent the segments of the dental benefits marketplace that have seen the most significant growth in recent years as ... [continue reading]
Last year we provided an update on what appeared to be a relatively small trend that has been seen over the years of insurance companies and third-party administrators (TPAs) using virtual stored value cards as a means of reimbursing dentists for care they provided to covered patients. Virtual stored value cards are virtual credit or debit ... [continue reading]
Efforts by the Ohio Dental Association, Ohio Department of Medicaid (ODM), Gov. Mike DeWine, Ohio General Assembly and other advocates to increase fees paid to dentists who treat patients covered by Ohio Medicaid will soon pay off as a new Medicaid dental fee schedule is slated to take effect on Jan. 1, 2024. The fee increase will be the first of ... [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. While the patient may benefit by having a lesser out-of-pocket expense, their multiple coverages can present administrative ... [continue reading]
The American Dental Association provides a free portal where dentists can input their credentialing information one time and provide it to third parties such as dental plans and other health care organizations. By utilizing the CAQH Provider Data Portal, dentists can enter their professional and practice information one time and submit it to ... [continue reading]
The ODA has been very active in advocating for a substantial increase in the state’s funding of Ohio’s dental Medicaid program. We have engaged state leaders for the last two years as we prepared for passage of the state’s budget for fiscal years 2024 and 2025. These efforts are paying off.
The state budget that passed the Ohio General ... [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.
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