Quarterly Newsletter

The new dental provider quarterly newsletter is designed to keep providers informed of changes and relevant information.

Provider quarterly newsletter, PDF opens new window

Electronic funds transfer and electronic remittance advice

Get paid faster and reduce administrative paperwork with electronic funds transfer (EFT) and electronic remittance advice (ERA). To start or update ERA and EFT, please sign in to the secure Dental portal and select the “Dental providers” dropdown at the top left of the page. The ERA/EFT link displays under the “Payments” menu.

DentalXChange

Want to save time and increase efficiency?

Submit claims online via DentalXChange, opens new window

HumanaDental issues digital member ID cards

Patients covered by a Humana Dental commercial group plan have the convenience of a digital member ID card and may no longer need to present a physical member ID card. They can use Humana tools to print a paper version of their card or email or fax a copy to your office. They also may present a digital ID card using their MyHumana mobile app. We ask that you accept a digital, fax or printed version of these patients’ ID cards.

For more information, refer to these frequently asked questions and answers.

HumanaDental digital member ID cards FAQs,PDF opens new window

Claim attachment guidelines

Before submitting a claim form to Humana, find out more about claim documentation.

Claim documentation, PDF opens new window

Code Dental Procedures and Nomenclature (CDT) updates

To review new and updated CDT codes for this year please refer to the document below.

CDT code changes, PDF opens new window

Medicare dental benefits

Are you part of the Humana Dental Medicare network or Careington Medicare Network in Florida? If so, please visit Humana Medicare Advantage Supplemental Dental Benefits Information to find the most recent dental office handbook, Humana Medicare Advantage dental benefit descriptions and member-specific dental plans.

Important information about Humana Medicare dental benefits, PDF opens new window

Mandatory Medicare compliance requirements

The HumanaDental Medicare network provides benefits to Humana members enrolled in Medicare Advantage and prescription drug plan programs. The Centers for Medicare & Medicaid Services mandates that all Humana-contracted entities, including those contracted with Humana subsidiaries, complete compliance requirements each year.

Mandatory Medicare compliance requirements, PDF opens new window

DHMO and Advantage network plan summaries

Are you part of the dental health maintenance organization (DHMO) or Advantage network? If so, you may want to review these plan summaries.

DHMO and Advantage network plan summaries, PDF opens new window

Federal Dental Plan Documents

If you treat patients with the Federal Dental Plan, you can review these exclusive provider organization (EPO) and preferred provider organization (PPO) plan summaries and helpful documents

EPO copay table, PDF opens new window

PPO schedule of benefits, PDF opens new window

First payer guidelines, PDF opens new window

Federal FAQs, PDF opens new window

Member summary information

The Humana Member Summary is a tool that displays patient-specific, clinically relevant information in a standardized format to help you identify opportunities to improve clinical outcomes and reduce medically related costs.

Member summary information

Third party network access

Updated May 2021—Humana enters into agreements that grant some third parties access to Humana’s contracted provider network. The provider agreement that dental providers enter into with Humana allows Humana to provide such third parties with access to Humana’s contracted provider network and in turn Humana’s contracted dental provider’s services. If a contracted dental provider no longer wants to have third parties accessing its services under the contract the dental provider and Humana entered into, the contracted dental provider can reach out to its Humana dental representative to be removed from third party access. Third parties with access to Humana’s contracted provider network:

  • Florida Combined Life (FCL)
  • Group & Pension Administrators (GPA)
  • Insurance Management Services (IMS)
  • New Benefits (NB)
  • TeamCare, a Central States Health Plan

Forms

W9

Some Humana networks may have additional participation criteria physicians and other healthcare providers must meet to be granted participation status. If you are eligible to use our online application, please review this important information.

Form W-9 (Rev. October 2018), PDF opens new window