Notice of Hearing
Changes in Reimbursement Rates and/or Methodology
For HealthChoice and Department of Corrections Dental Providers
[74 O.S. (2001) Section 1325]
3:00 p.m. October 5, 2012
Gene C. Howard Board Room
Fifth Floor – Landmark Towers
3545 N.W. 58th Street
Oklahoma City, OK 73112
Oklahoma State Statutes, Title 74, Chapter 37, Section 1325 requires the Employees Group Insurance Division (EGID) of the Office of Management and Enterprise Services to schedule a hearing thirty (30) days prior to adopting major changes to reimbursement rates or methodologies. EGID must notify providers at least fifteen (15) days prior to the hearing date. The hearing will be an open forum where providers will have the opportunity to comment on the proposed changes presented by EGID. In accordance with state statutes, this serves as notice regarding the date and time of this hearing:
- Discussion of Proposed Dental Provider reimbursement rates effective January 1, 2013.
EGID intends to adopt a dental fee schedule increase and methodology change effective January 1, 2013.
Currently, EGID develops a fee schedule for dental procedures based upon HealthChoice’s data of billed charges, a comparison to the Oklahoma Medicaid fee schedule or Oklahoma commercial payers, and EGID’s dental consultant’s recommendations.
In March, 2012, EGID established a Dental Advisory Panel consisting of members of the Oklahoma Dental Association and dental providers from several urban and rural areas of the state. EGID obtained detailed recommendations from the panel in early May. A meeting was held with the panel and EGID consultant Berkeley Research Group in August to respond to the panel’s recommendations. EGID and Berkeley Research Group developed a proposed reimbursement methodology of seventy-five percent (75%) of the National Dental Advisory Service median charge for the Oklahoma City area.
EGID’s proposed reimbursement methodology would increase the allowable fees overall to dental providers by approximately $5.8 million or 10% above the current fee allowables. This is a significant increase in fee schedule allowables, but more importantly, a consistent methodology will be adopted that will be updated on an annual basis.
In lieu of or in addition to your attendance at the hearing, your written comments are solicited for consideration.
All questions, comments or requests should be directed by phone to 405-717-8790 / toll-free 1-800-543-6044, by fax to 405-717-8977, by email to firstname.lastname@example.org, or by mail to:
EGID - Provider Relations
3545 N.W. 58th, Suite 110
Oklahoma City, Ok. 73112