Episodes of Care Earlier this year the Ohio Dental Association filed a formal complaint with the Ohio Department of Medicaid (ODM) concerning determinations made through ODM’s Episodes of Care payment program that many dentists had to return money for care provided to patients covered by Ohio Medicaid. Some dentists had been asked to return, ... [continue reading]
The Ohio Dental Association has lodged a formal complaint with the Ohio Department of Medicaid (ODM) concerning its Episodes of Care program. In a letter to Medicaid Director Maureen Corcoran, Dr. Thomas Kelly, ODA president, and Dr. Jennifer Kale, chair of the ODA Council on Access to Care and Public Service and ODA Medicaid Working Group, ... [continue reading]
The Ohio Dental Association has lodged a formal complaint with the Ohio Department of Medicaid (ODM) concerning its Episodes of Care program. Click here to view the letter. The ODA Medicaid Working Group strongly suggests that any dentist who has been notified that they must return money either directly to the state of Ohio or to one of the ... [continue reading]
The Centers for Medicare & Medicaid Services (CMS) recently clarified its rules prohibiting payment to providers, including dentists, who have formally opted out of participation in Medicare to not apply to supplemental benefits like dental benefits. This means that dental services provided by dentists who have opted out of Medicare may now be ... [continue reading]
Reports from the American Dental Association (ADA) and the Centers for Medicare and Medicaid Services (CMS) indicate a new federal law that took effect at the beginning of 2022 will very likely have an impact on most dental offices in Ohio and across the nation. The No Surprises Act is intended to provide consumers with new billing protections ... [continue reading]
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]
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 firstname.lastname@example.org by January 14, 2022.
Dentists may also ... [continue reading]
The Ohio Department of Medicaid reports that its next generation managed care program will go live July 1, 2022. In preparation for the next generation program, providers should contact the next generation managed care entities (MCE) that they are interested in contracting with to begin the process to join their provider networks. Provider ... [continue reading]
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]
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]
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