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

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 letter to House sponsors of DOC Access Act

June 04, 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 to Senate HELP Committee Re: Draft Lower Health Care Costs Act

June 05, 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

Comment Letter on NCOIL's Out-of-Network Balance Billing Transparency Model Act

August 31, 2017

Letter of Support to Rep. Carter - Dental and Optometric Care Access Act (HR 1606)

July 10, 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

Support Comment Letter to Rep. Gosar (R-AZ) Re: The Dental Insurance Fairness Act (HR 1798)

September 01, 2013

Support Comment Letter to Rep. Gosar (R-AZ) Re: The Competitive Health Insurance Reform Act (HR 911)

June 01, 2013