Is there a difference between an inlay and an onlay? Yes, there is and the difference is both in terms of clinical practice and benefits determinations. While the answer may seem obvious, the Ohio Dental Association continues to receive reports from third-party payers that some dentists may not fully appreciate the differences when submitting ... [continue reading]
As more dentists submit dental benefits claims electronically to third-party payers, the Ohio Dental Association has seen a marked decrease in the number of calls involving slow pay situations. The calls the ODA does receive now typically concern how much time an insurance company has to pay a claim.
Ohio does have a law governing insurance plan ... [continue reading]
The Ohio Dental Association is again receiving calls from dentists upset about the discounts they're being asked to give certain patients. A common theme among the callers is that the dentist has been directed to discount his/her fees for patients of plans the dentist has not signed a contract with.
How can this be? What’s the payer’s ... [continue reading]
There has been an increasing amount of talk around the country concerning dentists being audited by third-party payers. While some of the situations that have prompted this talk are applicable in Ohio, many are not.
For example, much attention has been focused on Medicaid Recovery Audit Contractors (RACs) in other states, and particularly ... [continue reading]
Dentists are becoming increasingly aware that they must take some type of action with respect to Medicare if they treat Medicare covered patients. So are those who would like to sell dentists products or services.
The Ohio Dental Association has received numerous calls from member dentists who have been solicited to attend seminars and/or purchase ... [continue reading]
How can an insurance company or even its dental consultant make treatment decisions about the care a dentist provides without ever seeing the patient? How can they make treatment decisions based on X-rays alone? The Ohio Dental Association receives many calls throughout the year from member dentists expressing these or similar concerns.
Many times ... [continue reading]
A national PPO has stopped its efforts to institute a dentist star rating system. The PPO is withdrawing its current program to rate the cost effectiveness of dentists in its network of participating providers but may develop an alternative plan at some point in the future.
The PPO’s actions appear to have affected many more dentists in ... [continue reading]
The newest version of the American Dental Association's "CDT 2015: Dental Procedure Codes" book takes effect Jan. 1, 2015, and is available to be ordered now. It contains 16 new and 52 revised procedure codes including new codes for post-operative visits, sealant repair, evaluation for deep sedation or general anesthesia and missed appointments. ... [continue reading]
A small number of dentists have contacted the Ohio Dental Association concerning a letter they received from a major national preferred provider organization (PPO). The letter described the PPO’s new program to rate the “cost effectiveness” of dentists within the PPO’s lines of participating provider networks.
The PPO is ... [continue reading]
“The ODA’s Dental Insurance Working Group often hears complaints from dentists concerning hassles in dealing with dental insurance companies,” said Dr. Manny Chopra, chairman of the Ohio Dental Association’s Council on Dental Care Programs and Dental Practice. “Pre-treatment estimates, inferences that a fee is too ... [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.
Internet Explorer Outdated
We have detected you are using Micorsoft Internet Explorer. This browser is outdated and Microsoft ended support for it in 2014.
You should switch to a modern, supported browser now. Modern websites, such as this, utilize modern technolgies and security that this outdated browser does not support. For a faster, safer, and more secure experience, please use a different browser.