Search

Frequently Asked Questions

Expand All add_circle_outline

Who is UnitedHealthcare?UnitedHealthcare® is an operating division of UnitedHealth Group, the largest single health carrier in the U.S.

 

We are committed to improving the health care system. 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

 

Learn more about us.

 

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). You could see the following brands being used in conjunction with the DBP logo. The brands include, but are not limited to:

  • AARP® Medicare Complete
  • Dental Benefit Providers of California
  • Dental Benefit Providers of Illinois
  • Golden Rule
  • Healthplex
  • National Pacific Dental
  • Nevada Pacific Dental
  • Pacific Union Dental
  • Solstice 
  • UnitedHealthOne

 

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 members.

What types of plans does UnitedHealthcare offer?
UnitedHealthcare® offers an array of insurance plans, including ones with dental coverage, employer-based plans, individual plans and plans that cover the Medicare and Medicaid demographics. While many are traditional PPO plans, we also offer DHMO, direct compensation, dental savings network and in-network only plans in select areas. To learn more, please take our Dental Products Overview course.

 

Does UnitedHealthcare offer dental plans in my area?
We offer dental plans throughout the U.S. A series of our plans provide coverage nationwide, while some are specific to geographical areas. For more information, please contact Provider Services at 800-822-5353.

 

What is a Dental Savings Network?
Dental Savings Network plans are not traditional plans, and members who purchase these plans are not fully insured. Instead of filing a claim, a member pays the provider directly based on a discounted rate.

How can I check member eligibility for my patient?
You can use the following methods to check a member’s eligibility for UnitedHealthcare® plan benefits.

 

UHCdental.com provider portal

  • Sign in to the provider portal and access the dashboard to search for an individual or family[AS1.1] by name, date of birth or subscriber ID

 

Electronic data interchange (EDI)

  • You can inquire about a member’s health care eligibility and benefits using transaction codes in EDI
  • EDI is set up through your practice management system and can be used for batch transactions. To learn about the benefits of EDI, how to set it up in your system and get troubleshooting assistance, visit the EDI information page or review this quick reference guide.

 

Where on the portal can I find if a member is eligible for benefits?
After logging into the portal, conduct an eligibility search by name, date of birth or subscriber ID to view eligibility status (select a date of service to confirm). If a member is eligible for benefits, a green “Eligible” icon will display under Insurance Information.

 

I rendered services to a member whose plan showed they were eligible for in-network benefits. After submitting the claim, I received notice that the member is not eligible. What can I do?The information obtained during the benefit breakdown prior to services rendered is not a guarantee of benefits. It’s important to provide appropriate financial disclosures to your patient with this information before the treatment is applied. If the services are not covered due to termination of benefits, your patient is responsible for the full amount of the services rendered.

Am I required to notify UnitedHealthcare of any changes to my practice?
Yes. The Centers for Medicare & Medicaid Services (CMS) mandates health care providers maintain accurate online directories. To help meet this requirement, you must review your directory every 90 days and notify us of changes, including:

  • Address updates
  • Tax ID information
  • Dentist leaving or joining the practice
  • Status of accepting or not accepting new patients

 

To make updates to your profile, go to UHCdental.com, sign in and select Provider Self Service under Quick Links, or use the Provider Information Demographic Change Submission Form.

 

What is your termination policy?
You must provide written notice 90 days prior to terminating your contract. Once the notification has been received, a network team member will reach out to you to discuss the next steps. Submit termination letters by:

  • Email: dbpprvfx@uhc.com
  • Fax: 855-363-9691
  • Mail:
    UnitedHealthcare – RMO
    ATTN: 400-Provider Services
    P.O. Box 30567
    Salt Lake City, UT 84130

 

Can I balance bill my member?
You may not balance bill the member if the services rendered are covered in the member’s plan. There may be instances when the services are not covered. For example, a member may have reached the annual and/or frequency limit. In these instances, the member is responsible for your full fee if the services are not covered in the plan — provided this information has been disclosed to the patient prior to services being rendered.