We take great pride in growing a robust provider network essential for the delivery of quality, accessible and affordable dental and health care services. With nearly 1.5 million members, we can help you to gain new patients and build your practice.
Dental Practitioner Specialties for Enrollment:
General Dentist, Endodontist, Oral Maxillofacial Surgery Orthodontist, Pediatric Dentist, Periodontist, Prosthodontist
- Once enrollment documents & contract are submitted, please allow up to 30 days for processing.
- You’ll need a new contract if there’s a change to your tax ID, your individual NPI changes to a group NPI, or you are already participating and joining a new dental group.
- To follow up on enrollment status, email Dental Provider relations, ExcellusDentalEnrollment@excellus.com.
- For providers located outside of our 31 county service area, please contact Dentemax
Please review the practice information that we have on file for you to ensure that it is up-to-date. This information is displayed in our Provider Directory and serves as a reference guide for members seeking your services. You can check this information in our Find a Doctor/Dentist tool.
Complete and submit our Practitioner Demographic Changes form to update:
- Practice and/or provider name
- Phone number, fax number, and/or address*
- Office hours
- Any other data changes that have occurred within your practice, displayed on the directory or not (see Join Our Dental Network section above for information on updating tax ID or NPI)
*When submitting address or service location updates: ¬ Service locations must be a street level address. PO boxes are not acceptable.
For your convenience, we’ve provided a link to view a sample ADA Dental Claim Form and instructions. This link includes instructions for reporting oral cavity, tooth numbers or tooth surfaces, and a guide to reporting D9985.
Dental Record Submission
Our Procedure Codes that Require Dental Record Submissionopen pdf grid includes information on the records needed for each procedure code listed. We recommend reviewing this grid prior to submitting claims so you can include any required dental records when you submit the claim.
Dental Claim Adjustment
When submitting the Dental Claim Adjustment Formopen pdf through the mail or electronically via the Smart Data Solutions (SDS Portal), be sure to include the other carrier explanation of benefits for a claim that denied for other carrier information. A corrected claim must be included for any changes to the original billed claim, including:
- Procedure code changes
- Change in patient information
- Change in charges
- Any change in provider information
For tip sheets, process documentation and other need-to-know dental information, please check out our staff training materials.
- Tour Dental Resources - video (click to download) - 10.1MB
- Navigating the Blues Dental GuidebookOpen the PDF
- Smart Data Solutions (SDS) Provider Submission Portal Information
- Tips for Completing the CMS-1500 FormOpen the PDF (for submitting a claim for oral sleep apnea)
If you are still receiving paper payments and remittances, we encourage you to transition to EFT/ERAs as soon as possible. Visit www.instamed.com or call 1-866-467-8263 for more information.