Insurance Reimbursement
The changing healthcare landscape is altering the way insurers pay practitioners. AAOMS remains committed to working with all parties to ensure the best outcome for its members and their patients. Please visit the Coding and Reimbursement page of AAOMS.org for additional information on this issue.
Trending State Issues: Out-of-network/Surprise Billing
With the narrowing of provider networks, patients are increasingly receiving out-of-network bills for services provided at in-network facilities. Despite the adoption of model legislation by the National Conference of Insurance Legislators in 2017, only a handful of states have introduced similar language. Because OMSs provide services at hospitals, they will likely be disproportionately affected by these bills compared to the rest of the dental community. Proposals have been introduced that require out-of-network providers to be reimbursed at a specified percentage of the usual and customary rate for the geographic area, require providers to accept assignment of benefits, prohibit balance billing, mandate arbitration or require specified patient notification before a provider can balance bill a patient.
For more information on the issues facing your state, please view the state legislative tracking map, listen to the most recent Advocacy Flash Update or contact the AAOMS Government Affairs Department.
- Comment Letters
- Date
AAOMS comments to CMS on dental codes for CY 2025 APC assignment
- February 28, 2024
AAOMS comments to CMS for CY 2025 ASC Covered Procedures List
- February 28, 2024
AAOMS comments to CMS on dental claim form acceptance
- February 06, 2024
ODC Comment letter to NCOIL Re: Medical Loss Ratios (MLR) for Dental Health Care Services Plans Model Act
- July 19, 2023
AAOMS comment letter to NCOIL Re: Medical Loss Ratios (MLR) for Dental Health Care Services Plans Model Act
- February 22, 2023
AAOMS recommendations to CMS for addition to the ASC Covered Procedures List for CY 2024
- February 07, 2023
AAOMS dental recommendations to CMS for CY 2024
- January 30, 2023
AAOMS comment re: Request for Information on Advanced Explanation of Benefits, GFE
- November 04, 2022
AAOMS comment re: Surprise Billing Requirements: GFE, patient-provider dispute resolution
- January 21, 2022
AAOMS comment re: Surprise Billing Requirements: QPA, Notice and Consent, Disclosures
- March 28, 2022
AAOMS comment re: NSA Complaints Submission Process
- March 28, 2022
AAOMS Comments re: Surprise Billing IRF Part II
- December 03, 2021
AAOMS thank you ltr to Manchin and Cramer re DOC Access
- June 04, 2021
AAOMS Comments re: Dec 2020 Surprise billing legislative proposal
- December 17, 2020
Coalition letter re: PPP for 501c6 organizations
- December 11, 2020
AAOMS letter to sponsors in support of the Dental and Optometric Care (DOC) Access Act (S 4894)
- December 01, 2020
ODC-NCOIL Dental Model
- September 22, 2020
NCOIL Patient Dental Care Bill of Rights
- September 17, 2020
Coalition letter in support of NCOIL Patient Dental Care Bill of Rights
- February 25, 2020
NCOIL Patient Dental Care Bill of Rights
- February 21, 2020
AAOMS Comments to House W&M Committee re: Consumer Protections Against Surprise Medical Bills Act
- February 11, 2020
DOC Access TY Loebsack Carter ODC
- October 16, 2019
AAOMS Comments RE: E&C Suprise Billing Draft
- June 04, 2019
Coalition Comment Letter on NCOIL's Out-of-Network Balance Billing Transparency Model Act
- September 06, 2017
Coalition Letter to House Committee on Education & the Workforce Re: Support for the Dental Insurance Fairness Act (HR 1677)
- April 17, 2015
Support letter sent to Rep. Buddy Carter re: HR 3323, a bill to cap fees on non-covered services
- December 01, 2015