Dental Provider FAQ
Answers to commonly asked questions about dental network participation.
Who is my dental network manager?
Our dental network managers are available to answer your questions and support you and your staff. Each state has a designated dental network manager. You can find your dental network manager on our provider website at the Contact us page.
How can I verify my patients’ benefits and eligibility?
You can find patient information and process claims reimbursement quickly and easily through Availity Essentials or MyDentalCoverage. Learn more and register.
How do I register for Availity?
Create an account at Availity Essentials.
For technical support, please call 1-800-282-4548.
Where can I find a reimbursement schedule?
Reimbursement schedules and pricing tools are available at our online portal, Availity Essentials.
Who do I contact if I need 1099 form assistance?
If you need assistance with your 1099, please call 1-866-445-5148 toll-free. You’ll be connected to an automated answering system that can answer all commonly asked questions 24/7. You can also speak with a live representative during business hours if you need additional assistance.
What if I still need help?
You can find the number of a representative who can help you on our Contact us page.
How do I know whether my patient has transitioned to the new service platform?
Perform an eligibility and benefit inquiry on Availity Essentials. If the member has transitioned, the response you receive will include a message stating that the member is on the new MyDentalCoverage platform.
How do pre-determinations work?
The patient cost estimator is no longer available on Availity for dental business, for cost estimations for non-transitioned members please file a pre-determination on Availity Essentials. All other members submit pre-determinations on MyDentalCoverage or use the online cost estimator.
Benefits will be predetermined under the assumption that Regence is the primary insurer. If the patient is insured under more than one policy, actual benefits payable may be adjusted due to coordination of benefits (COB) or maintenance (non-duplication) of benefits (MOB).
Predeterminations are provided as a courtesy and are not a guarantee of payment. All services are subject to the benefits, eligibility and maximum allowable amounts in effect on the actual date of service. Estimated payment may be reduced due to prior payments for treatment. Actual benefits payable will depend upon the following:
- Benefits available
- Member contract limitations
- Provider participating status
- Patient and provider eligibility
- Benefit maximums in effect when the services are completed
How do I estimate member costs?
The cost estimator is no longer available in Availity. To receive estimated costs you will need to submit a pre-determination through the Availity portal. For a member who has transitioned to the new platform, please visit MyDentalCoverage.com.