Eligibility Search Information
There are two ways to which you can search for a member. We encourage using Subscriber ID as the primary way to search. However, we also allow you the ability to search by the member's name and date of birth. If more than one record is found, you will be asked to enter in additional information.
Applicable to DHMO provider groups with assigned members
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Provider Services: Claims Submission Addresses:
1-800-822-5353 United Healthcare Dental Claims Unit
P.O. Box 30567 Salt Lake City, UT 84130-0567
Click here for Healthplex claims submission addresses
Electronic Payer ID:
521337971
IMPORTANT MESSAGE TO HEALTHPLEX PROVIDERS:
Effective Nov. 1, 2024, TWU local 100 will be terminating its dental plan insured by Dentcare. Healthplex will no longer administer the dental benefits for the TWU Local 100 plans and DMOHP01 network.
Healthplex will continue to process claims for treatment dates on or before Oct. 31, 2024. Claims should be submitted within 90 days after the date of service to avoid claim dential due to late filing.
Healthplex continues to serve as the administrator for Commercial and Government dental plans.
Effective Jan. 1, 2024, Healthplex has changed the systems used to administer dental plans. Please review the Client reference guide for the updated information about the provider portal, provider services phone number, and claims addresses.
Use UHCdental.com to verify eligibility, plan coverage, online claim/pre-treatment/pre-authorization submission, and more. Please review the UHCdental.com user guide and training course.
Updates and information to help practices thrive:
The Hawaii General Excise Tax (GET) is tax that is charged on business activity in Hawaii. The Fee Amounts listed in our Preferred Provider Organization (PPO)/Medicare and Medicaid Fee Schedules are all inclusive, including, without limitation, reimbursement for any/all applicable state and federal taxes. Providers may not seek payment from enrollees for General Excise taxes. If you have any further questions, please contact UnitedHealthcare Provider Services at 1-800-822-5353
Please read this important announcement regarding PPE for New York Providers.
December 2024 UnitedHealthcare Dental Policy Update Bulletin Now Available.
American Dental Association (ADA) and CAQH ProView credentialing process for dentists.
Utilization Management Decision Making:
Utilization management decision making is based only on appropriateness of care and service and existence of coverage. The organization does not specifically reward practitioners or other individuals for issuing denials of coverage. Financial incentives for Utilization management decision makers do not encourage decisions that result in underutilization.
Limited benefit availability for Leased Network Providers, DHMO, Fixed INO, Fixed EPO, Direct Compensation and Referral Plans
At this time, you will not be able to retrieve procedure code pricing (i.e fee schedule) for these plans.