A participating dentist has signed a contractual agreement with United Concordia to follow TDP
rules for providing care and accepting payments. When using a participating dentist, you will
never have to pay more than the applicable cost-share percentage for covered services, subject to stated limitations and maximums. Specifically, United Concordia participating dentists agree to:
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Accept United Concordia's allowance for covered services as payment in full, charging
the enrollee only the applicable cost-share percentage. Balance billing by participating
dentists is prohibited. Enrollees do not have to pay any part of the dentist's charge that
exceeds United Concordia's allowance, except when
alternate/optional services are provided.
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Accept direct payment from United Concordia for covered services. United Concordia sends
the benefit payment directly to the dentist. The enrollee will receive a Dental
Explanation of Benefits (DEOB) noting the payment amount and any cost-share.
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Complete the
claim form at no extra charge and submit it to United Concordia on your behalf
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Participate in United Concordia's quality assurance programs
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Submit predetermination requests, as appropriate
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Provide any information needed by United Concordia to make coverage and payment determinations
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Complete the
DD Form 2813, DoD Active Duty/Reserve Forces Dental Examination, for National Guard/Reserve members
To find a participating dentist, use our Find
a Participating Dentist tool.
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