Category: Dental Insurance & Medicaid

Imagine this: You’re a dentist with a few open slots in your weekly schedule. You’ve got the staff, the space, and the skills — but those chairs aren’t always full. What if filling just two to six of those slots each week could bring in an extra $50,000 to $110,000 a year? That’s not a hypothetical. It’s happening right now in ... [continue reading]

On occasion, the Ohio Dental Association receives calls from member dentists who provide dental care to their employees as an employee benefit and have questions regarding the proper way to bill for their services if the employee also happens to have a dental benefit through another source, like a spouse. Regulatory considerations It is legal ... [continue reading]

The Ohio Dental Association features many resources to help members navigate Medicaid and Medicare. Institutional credibility of the ODA with Medicaid, coupled with individual personal relationships between the ODA volunteer dentists and ODA staff with individual policymakers and decisionmakers within the Ohio Department of Medicaid (ODM), ... [continue reading]

The Ohio Department of Health recently released the results of its “Oral Health Screening Survey of Third Grade Schoolchildren in Ohio, 2023-2024.” The results of the screening survey were similar to the most recent previous survey from 2017-18. For example, the 2023-24 survey showed that 51% of the screened children have a history of tooth ... [continue reading]

Ohio’s Medicaid program provides publicly funded health care coverage to about 3 million low-income Ohioans (or about 26% of the state’s population), including children, pregnant women, older adults, people with disabilities and other adults. It is jointly funded by a roughly 65-35 split of federal to state tax dollars for most Medicaid ... [continue reading]

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 claims. Problems ... [continue reading]

Despite the best efforts of all involved, insurance companies and other third-party payers mistakenly issue payments to dentists that they later determine should not have been made in the first place. This practice happens enough that the American Dental Association has listed overpayment recovery/refund requests in its list of top 10 concerns ... [continue reading]

Last month, this column focused on the ODA’s efforts through the Medicaid Working Group to help individual ODA member dentists address Medicaid related problems that they are unable to resolve on their own. This month’s column will cover how the ODA helps individual member dentists deal with privately funded dental insurance related ... [continue reading]

The 135th General Assembly enacted legislation, Senate Bill 40, in 2024 that adds common sense fairness back to the dental insurance system. This new law prohibits dental insurance companies from dictating fees for services that the insurers do not even cover. Any new contracts entered into from Jan. 1, 2025 on, must be compliant with the new ... [continue reading]

As many of you know, starting in January of 2024, dental Medicaid reimbursements in Ohio increased on average by 93% per procedure. This across-the-board increase was the result of years of advocacy by the ODA and its member dentists urging policymakers to address the deficiencies in the dental Medicaid program. These reimbursement increases ... [continue reading]