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Frequently Asked Questions
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Company Information Products Contractual Join Our Network
Company Information
                 
►   ▼   1. Who is UnitedHealthcare?

At UnitedHealthcare, we are committed to improving the health care system.

UnitedHealthcare is an operating division of UnitedHealth Group, the largest single health carrier in the United States.

As a recognized leader in the health and well-being industry, we strive to:

  • Improve the quality and effectiveness of health care for all Americans
  • Enhance access to health benefits
  • Create products and services that make health care more affordable
  • Use technology to make the health care system easier to navigate

Our family of companies delivers innovative products and services to approximately 70 million Americans. UnitedHealthcare's nationwide network includes 768,471 physicians and health care professionals, 80,000 dentists and 5,675 hospitals. Our pharmaceutical management programs provide more affordable access to drugs for 13 million people.

We're committed to the delivery of quality care and its continual improvement. In fact, UnitedHealth Group made significant investments in research and development, technology and business process improvements – nearly $3 billion in the past five years. These investments led to changes that are improving the way care is delivered and administered across the entire industry.

          
►   ▼   2. What brands are under the UnitedHealthcare "umbrella"?

You may see a variety of names on a member's card. Our dental provider network is most popularly known as Dental Benefit Providers (DBP).However, at times, you could see the following brands being used in conjunction with the DBP logo. The brands include, but are not limited to:

  • Dental Benefit Providers of California
  • Dental Benefit Providers of Illinois
  • National Pacific Dental
  • Nevada Pacific Dental
  • Pacific Union Dental
  • GoldenRule
  • AARP Medicare Complete
  • UnitedHealthOne
  • HealthAllies
  • Healthplex

We also have a variety of private label plans that will not show the UnitedHealthcare logo. Please refer to the member's card for contact information for those particular members.

          
►   ▼   3. Is there a phone number I can call for Customer Service?

Our customer service team can be reached at 800-445-9090.

          
►   ▼   4. What are your hours of operation?

Our customer service team is available Monday through Friday from 7 am to 10 pm CST.

 

                         
Products
                 
►   ▼   1. What types of plans does UnitedHealthcare offer?

UnitedHealthcare offers an array of insurance plans, including dental plans. We also have traditional employer based plans as well as plans that are administered for the Medicare and Medicaid demographics. While most of our plans are the traditional PPO plans, in select areas, we offer DHMO, Direct Compensation, Discount and In Network Only plans.

          
►   ▼   2. Does UnitedHealthcare offer dental plans in my area?

We offer plans throughout the United States. While some plans are specific to geographical areas, we do have plans with nationwide coverage. To obtain more information, you can contact our customer service team for further assistance.

          
►   ▼   3. What are EHB plans?

Essential Health Benefit plans are those that were created due to the Affordable Care Act. The plans are offered through the "Marketplace". These plans were created to have certain dental benefits embedded with the member's medical plan to ensure coverage for certain services. Every medical plan purchased through the marketplace will have certain dental coverage for pediatric benefits; however, that does not mean that the member has a fully insured dental plan.

          
►   ▼   4. What is a discount plan?

Discount plans not traditional plans and are not fully insured. Therefore, instead of filing a claim, the member would pay you directly based on a discounted rate. These members purchase these plans as well.

          
►   ▼   5. Where can I find information on Medicare?

Please click here and you will be routed to the Medicare page to learn more.

                         
Contractual
                 
►   ▼   1. Are we required to notify UnitedHealthcare of any changes to my practice?

We do ask that your office notifies us whenever there are changes to the practice. Common reasons can be, but not limited to: address changes, Tax ID changes, a dentist leaving the practice, or a new dentist joining the practice.

          
►   ▼   2. Can I balance bill my member?

As a participating provider, you may not balance bill the member if the service is covered. However, there may be times where the services that may not be covered on the member's plan. For example, a member may have met his annual limit or has met the frequency limitation. The member is responsible for your full fee if the services are not covered provided this information has been disclosed to the patient prior to services being rendered.

          
►   ▼   3. Can I add a network to allow for new members to access my office in network?

Absolutely! You can click Join the Network and fill out the appropriate paperwork. Once the paperwork is received, a recruiter will contact you and discuss how the plan is reimbursed and next steps.

          
►   ▼   4. Do I have to remain in network for a period of time before terminating my contract?

We ask that you satisfy a year on the contract before requesting any changes.

          
►   ▼   5. What is your termination policy?

We require 90 days written notice to terminate the contract. Once the notification has been received, a recruiter will reach out to you to discuss the next steps. The letter can be faxed to 877-572-3043.

          
►   ▼   6. Are you a leased network provider?

If you are one of our valued leased network providers, we want to remind you that you have access to the following resources on this website (uhcdental.com):

  • Eligibility and Benefits
  • Claim Status
  • Clinical Guidelines
  • Submit Claims
  • Set Up Electronic Claim Payments
  • Fee Schedule Requests


Important: If the request pertains to the following, you are required to contact the leased network in which you participate:

  • Fee/Contractual Negotiations
  • Contract Requests
  • Demographic Updates (e.g. name, address, phone, tax information, etc.)
  • Credentialing/Re-Credentialing
  • Termination/Opt Out Requests

For more Leased Network Provider information, please login for document access to "Leased Partner FAQ and Resource Information".

 

                         
Join Our Network
                 
►   ▼   1. Do I have to join every network UnitedHealthcare offers in my area?

While we would appreciate your dentist to join all available networks in your area, it is not required.

          
►   ▼   2. Is there a charge to join the network?

There is no charge or membership fee to join the network.

          
►   ▼   3. How long will it take for the dentist to be a participating provider?

Our credentialing process takes approximately 90 days to complete.

          
►   ▼   4. Does DBP participate in CAQH?

We do!  On the DBP application, there is a section called CAQH ID.  This is where you would indicate your CAQH ID number. 

          
►   ▼   5. I have submitted all of the required documents as notated on your page. What happens next?

In most cases, once you have submitted the documents from the Join the Network page, your local recruiter will be in contact with you.  The recruiter will discuss what was received as well as the contracted rates for the plans in your area.  At that point, the recruiter will send a contract to you so that the owner of the practice may sign.

If the contract has not been returned, or if any part of the application is incomplete, we will not be able to move forward with credentialing the dentist until that information is received.  In turn, this will delay us in activiating the dentist as in network. 

                         
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    Assignment Status
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Dental Account Summary

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Annual Maximum Benefits - Dental
Deductible
Lifetime Maximum Benefits - Orthodontics

Benefit Details

Procedure Category Procedure Category Description Coverage({{memberNetworkShort}}) Deductible Applies Waiting Period Met Date
{{onceData.procedureCategory.codeValue}} {{onceData.procedureCategory.codeDesc | uppercase}} {{onceData.coveragePct}}% {{onceData.deductibleApplies}} {{onceData.waitingPeriodMetDate | date: "MM/dd/yyyy"}}N/A

Latest 10 service dates were displayed in the below table for each procedure code. If you wish to see more info please use Utilization Search

ADA Code ADA Description Procedure Category Service Dates Service Date Procedure Code Frequency* (i-ii-iii) Age Limit Alternate Benefit Related Codes
{{historyData.procedure.codeValue}} {{historyData.procedure.codeDesc}} {{historyData.procedureCategory}} {{historyData.services[0].serviceDate == null || historyData.services[0].serviceDate == ""? "-" : historyData.services[0].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[1].serviceDate == null || historyData.services[1].serviceDate == "" ? "-" : historyData.services[1].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[2].serviceDate == null || historyData.services[2].serviceDate == ""? "-" : historyData.services[2].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[3].serviceDate == null || historyData.services[3].serviceDate == ""? "-" : historyData.services[3].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[4].serviceDate == null || historyData.services[0].serviceDate == ""? "-" : historyData.services[4].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[5].serviceDate == null || historyData.services[1].serviceDate == "" ? "-" : historyData.services[5].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[6].serviceDate == null || historyData.services[2].serviceDate == ""? "-" : historyData.services[6].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[7].serviceDate == null || historyData.services[3].serviceDate == ""? "-" : historyData.services[7].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[8].serviceDate == null || historyData.services[0].serviceDate == ""? "-" : historyData.services[8].serviceDate | date: "MM/dd/yyyy"}} {{historyData.services[9].serviceDate == null || historyData.services[1].serviceDate == "" ? "-" : historyData.services[9].serviceDate | date: "MM/dd/yyyy"}} {{historyData.inNetworkFrequency != null && historyData.inNetworkFrequency != undefined && historyData.inNetworkFrequency.length>0 ? historyData.inNetworkFrequency : historyData.outOfNetworkFrequency != null && historyData.outOfNetworkFrequency != undefined ? historyData.outOfNetworkFrequency : 'NA'}} {{historyData.ageLimit == null || historyData.ageLimit == "" ? "NA" : historyData.ageLimit}} {{historyData.alternateBenefit == null || historyData.alternateBenefit == "" ? "NA" : historyData.alternateBenefit}} {{historyData.relatedCode == null || historyData.relatedCode == "" ? "NA" : historyData.relatedCode}}
* Frequency Definition: i = Number of Procedure (999 = unlimited); ii = ProcedureFrequency Type (C=Calendar Year, F=Floating, P=Plan Year); iii = Period and Timeframe(D=Day, M=Month, Y=Year) Example: 1 F 36M read as 1 Procedure per 36 Floating Months
Subscriber ID Amount Claimed Claim Status View
{{item.member.memberId | maskNumber}} $ {{item.totalCharge}} {{item.claimStatusCode.codeDesc}}
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Date Last Edited Treatment Plan Name Member Name View Plan
{{item.lastUpdateDate | date: "MM/dd/yyyy"}} {{item.treatmentName}} {{item.memberName}} Details
Link to copay schedule

Claims Address Payor Id:
UNITED HEALTH CARE DENTAL CLAIMS PO BOX 30567 SALT LAKE CITY, UT 84130-0567
521337971