INSURANCE CHALLENGES? TAP INTO ODA EXPERTISE
As a benefit of your membership, the Ohio Dental Association has several avenues to provide you with support and assistance with the challenges that come with navigating insurance relationships.
The ODA Dental Insurance Working Group (DIWG) has served for many years as an advocate and counselor to ODA members who have encountered problems with third-party payers. The DIWG is comprised of a dedicated group of ODA member dentists who volunteer their time to determine the ODA’s formal role in addressing dental insurance-related questions, concerns and complaints involving dental insurance and third-party payers that are submitted by ODA member dentists.
Dentists who volunteer on the ODA’s Dental Insurance Working Group have helped individual members with dental insurance matters they have been unable to resolve on their own for over 20 years. In the last few years alone, the working group has led successful ODA advocacy efforts to:
- Halt a major dental insurance company’s post payment audit with possible financial penalties that accompanied the audit of a Cincinnati dentist who was no longer part of the insurer’s participating provider network.
- Assist a Dayton area dentist in obtaining over $12,000 in previously denied crown claim payments.
- Assist a Cincinnati dentist in obtaining over $1,200 in previously denied crown claim payments.
- Assist a Greater Cleveland area dentist in obtaining over $4,800 in previously denied crown claim payments.
- Assist a Greater Cleveland area dentist in obtaining over $1,200 in previously denied crown claim payments.
If you have been unsuccessful in resolving a third-party payer situation on your own, consider submitting your issue to the DIWG by sending all supporting documentation (with personal health information redacted) to the ODA Dental Insurance Working Group at 1370 Dublin Rd., Columbus, Ohio 43215 or via fax at (614) 486-0381 or via email to chrism@oda.org. You can also submit the documentation via our secure online form by clicking here.
In addition to the DIWG, ODA staff is available to answer questions about dental insurance and third-party payer information as a benefit of your membership. ODA Director of Dental Services Chris Moore has more than 35 years of experience navigating dental insurance and third-party payer issues and is available by phone or email to speak to ODA members and answer specific questions. Contact him by calling (800) 282-1526 or emailing chrism@oda.org.
The ODA and American Dental Association also provide dentists with an Insurance Contract Analysis service to help you get a clear, concise explanation of the terms of a provider plan and contract before you decide to participate. This complimentary service is an exclusive ODA member benefit. If you would like to utilize the Insurance Contract Analysis Service, please send a copy of your unsigned contract to dentist@oda.org.
Plus, you can find resources on our website by clicking here to help you navigate insurance and third-party payer issues including past Dental Insurance Corner articles.
The ODA has the expertise, connections with insurance companies, and the strength of the membership behind us to help answer your questions and navigate issues you may be having with insurance companies. Contact us at (800) 282-1526 or dentist@oda.org for assistance.
