Participating with United Concordia

Enrollees may receive dental care from any licensed dentist of their choice. However, members are encouraged to visit the offices of participating dentists with the understanding that it will save them time, paperwork and money.

A licensed dentist who is not currently excluded, sanctioned or suspended by your licensing authority, is eligible to become a United Concordia participating dentist. Participating dentists agree to accept United Concordia's allowance as payment in full for covered services, collect patient cost shares and submit claims to United Concordia on behalf of United Concordia members. Please refer to the Participating Dentist Agreement at the end of this section for a complete list of participating dentist obligations.

Advantages of Participation
Participating dentists are an important part of the United Concordia network. There are participating dentists in every clinical specialty, and in all 50 United States, the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands. United Concordia is dedicated to fostering a mutually beneficial relationship with participating dentists by offering the following business incentives:

1. All payments for services are mailed directly to participating dentists.
2. Names, addresses, and phone numbers of participating dentists are regularly made available to all members on our web site.
3. Participating dentists servicing our members receive United Concordia's quarterly newsletter.
4. Participating dentists servicing our members will receive the Reference Guide and any subsequent updates.
5. Participating dentists may be eligible to participate in the HONORS program. This program recognizes participating dentists who consistently provide cost-effective care to our customers by relaxing the requirement for radiograph submissions and other clinical documentation.

How to Become a Participating Dentist
To be eligible to participate in United Concordia's PPO networks a dentist must:

1. Demonstrate a Utilization Review Pattern acceptable to United Concordia; Complete a United Concordia Credentialing Application (the law requires dentists in certain states to submit a state specific application).
2. Complete a signed Participating Dentist Agreement with United Concordia Companies, Inc. (the law requires dentists in certain states to submit a state specific agreement).
3. Hold an active, valid license to practice dentistry in the state(s) in which he/she practices.
4. Hold current professional liability insurance.
5. Have no current sanction, termination or other peer review action by a professional review body; state dental board or Health and Human Service (HHS).
6. Hold an active unrestricted federal Drug Enforcement Agency (DEA) certificate, if applicable.

Any negative report on the attestation will be investigated. Additional information may be necessary in certain states due to state specific requirements.

All paperwork and supporting documentation should be forwarded to:

      United Concordia Companies, Inc.
      Provider Data Management
      P.O. Box 69415
      Harrisburg, PA 17106-9415
      Fax (717) 260-6834

You will be notified in writing of your assigned provider number and effective date of participation.