Category: Dental Insurance & Medicaid

Christopher A. Moore, MA - ODA Director of Dental Services Laws affecting dental insurance and dental benefit plans can significantly impact the typical dental practice. Ohio dentists should be aware of three pieces of legislation considered by the just completed session of the state legislature that will likely be re-introduced in some form to ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services      Please note the following information is generally applicable in situations where the dentist is not contracting with the third-party payer. In contracting situations, the dentist needs to adhere to the terms of his or her contract with the third-party ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services Should dentists receive third party payer reimbursement for providing dental services to family members? The American Dental Association says yes, but some insurance plans say no. The Ohio Dental Association has recently received a number of calls from member dentists who have received ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services      The Ohio Dental Association House of Delegates (HOD) addressed three dental insurance issues during its just completed annual meeting in Columbus. The House’s actions established official policy on silent preferred provider organizations (PPOs), craniofacial ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services       Over the past year the Ohio Dental Association has received a very small but increasing number of reports from ODA member dentists concerning letters they have received from insurance companies relative to utilization review related issues. Both contracting ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services        Dental insurance and other forms of third party payment are both a boon and a bane for most dentists.      On the good side, dental insurance provides a powerful incentive for individuals to obtain dental care. People (and their ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services          In the March issue of the ODA Today, this column reported on a controversial payment method that some third party administrators (TPAs) had begun using as a means of reimbursing dentists who have provided care to patients covered by ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services The newest version of the American Dental Association’s Current Dental Terminology (CDT) will take effect on January 1, 2013. It will be the culmination of much work at the ADA and particularly the ADA Council on Dental Benefit Programs (CDBP) and its newly formed Code Advisory ... [continue reading]

Christopher A. Moore, MA - ODA Director of Dental Services      Two more third party administrators (TPAs) have begun using a controversial payment method as a means of reimbursing dentists who have provided care to patients covered by self-funded/self-insured benefit plans that utilize the TPAs’ administrative ... [continue reading]

For over a decade Ohio has had a law that provides protections for consumers whose health insurance claims have been denied or reduced in coverage. The law, the Patient Protection Act of 1999, grants consumers the right to request an appeal of their insurer’s decision and provides them with “the opportunity to request an independent, external ... [continue reading]