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Your passion brings smiles to so many faces

At Humana, we work hard to help your patients get access to care. Our plans offer three prophylaxis cleanings, unlimited and extended maximums and four periodontal maintenance cleanings a year. Doing more for the health of your patients is what we call human care.

Humana dental patient smiling at camera
Join our network Credentialing of healthcare professionals

Thank you for your interest in Humana. You can choose to participate in our Preferred Provider (PPO) network, Managed Dental Care (DHMO) network, Humana Advantage Plan (EPO) network, or all three. If you would like more information on participating in the HumanaDental® network, please complete the online form:

Complete online form, opens new window

What’s next?

A Humana contracting representative will review your request and contact you to initiate a participation agreement. You’ll have an opportunity to review the agreement and be asked to sign it and return it to Humana. Credentialing may be required before an agreement becomes effective, and you may be asked for additional information to complete credentialing. Once credentialing is complete, you’ll receive a copy of the contract. It will be signed by a Humana representative, and you will be advised of your effective date with Humana.

If you’re a member and interested in referring your dentist to participate in the HumanaDental network, please use our refer a dentist form.

Credentialing is the process of obtaining and reviewing documentation to determine participation status in a health plan. The documentation may include, but not be limited to, the applicant’s education, training, clinical privileges, experience, licensure, accreditation, certifications, professional liability insurance, malpractice history and professional competence. Generally, the terms credentialing and recredentialing include the review of the information and documentation collected, as well as verification that the information is accurate and complete.

Please note:

 

Credentialing process

Andros processes dental credentialing and recredentialing applications on behalf of Humana.

Humana encourages the use of the CAQH application. These electronic methods provide a fast and easy way to securely submit credentialing information to multiple plans and networks by entering information just once. Application data can be submitted online at any time. The simplified credentialing process reduces paperwork and saves time. It is provided at no cost to your practice.

To become credentialed for the first time, you will need a current and complete CAQH application and should include the following:

  • All information is completed on the form or marked as “not applicable.”
  • All prior and current practice locations should be included on the application.
  • Identification numbers such as the provider’s Social Security number, National Provider Identifier (NPI), Drug Enforcement Agency (DEA) and professional license number.
  • All questions answered, including any necessary explanation.
  • Attestation, signature and date should be within 180 days.
  • Highest degree of education in MM/YYYY format, and needs to include city and state.
  • Digital (scanned) copies of your:
    • Curriculum vitae or work history in a MM/YYYY format for the past 5 years, and any gaps greater than 6 months need to be explained.
    • Malpractice insurance, and it must not expire within 60 days of your application and should include coverage period with aggregate and occurrence dollar amounts.

 

How Do I Become Credentialed?

Once you have completed the contracting process, please follow the below options for completing recruiting. For providers with a CAQH ID, visit www.ada.org/credentialing, opens in new window and do the following:

  1. Create a username and password
  2. Create a user profile
  3. The system will ask if you have a CAQH ID. A “Yes” answer prompts you to enter your CAQH number.
  4. You will receive an email confirmation to re-attest in ProviderSource.

 

Humana encourages the use of electronic credentialing methods*; however, if you are unable to complete an electronic application, please work with your contracting representative on obtaining a paper application.

*Note: The following states require the use of CAQH, opens in new window:

  • Colorado
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Maryland
  • Missouri
  • Nevada
  • New Jersey
  • New Mexico
  • North Carolina
  • Ohio
  • Oklahoma
  • Tennessee
  • Texas
  • Vermont
  • Washington District of Columbia
  • West Virginia