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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

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Dental Provider Resources

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You asked, we delivered. Your online dental claims, eligibility and benefits website has changed! 
 

Based on your input, we launched a brand new dental provider website. All the functions from our previous sites are now consolidated into a new dental web portal powered by Availity including enhancements and upgrades, making it easier to do business with us.

The new and improved website is available NOW. Visit www.availity.com/dentalproviders.

 
What you need to know 
You get one easy website for claims and attachments. Click here to read more.
Check eligibility and benefits, manage claims, view remittances, and complete secured administrative tasks online.
If you currently don't have an account set up with Availity, you can easily create one. (Once you're set up, remember to bookmark the new site for quick access every time.)
Training is free online and available at your convenience. There's no need to schedule.
More detailed information about the new web portal is available in the FAQ.
To register for the new portal, visit www.availity.com/dentalproviders and select Register in the upper right corner. Already registered? If so, now is the time to make sure your tax IDs and other important information are registered on the new web portal. 
Our strong membership provides an opportunity for you to grow your business. 
 
Dental Provider Online Portals:  
Anthem Online Portal

Eligibility, benefits, claim status, and electronic claim submission for Anthem’s Prime, Complete, and Smart Access members.

 
SecureTrack Online Portal

Eligibility, benefits, claim status, and electronic claim submission for all other Anthem members.

 
Tools for Dental Providers
Electronic Data Interchange (EDI) Services
National Provider Identifier (NPI) Registration
Dental ERA Form
Dental EFT Form
HLD Index Score Sheet
 
Communication/Notifications
CDT Updates Effective 1/1/2018
CDT Updates Effective 1/1/2018
Dental Newsletter – Summer 2018
Dental Newsletter – Winter 2017
Dental Newsletter – Spring 2017
Dental Newsletter – Winter 2016
Dental Newsletter – Summer 2016
Dental Newsletter – Fall 2015
Dental E-Newsletter - Summer 2015
 
Forms
Dental Claim Form
Electronic ID Cards – Dental Quick Reference Guide
Standardized Maintenance Form
Dental W-9 Form
Dental Review Guidelines
 
Clinical Policies
01-101 Prophylaxis
02-701 Crowns Inlays and Onlays
02-901 Crown Buildup
02-902 Veneers
03-001 Endodontic Therapy
03-401 Biological Materials Tissue Grafting – Endontic
04-201 Bone Grafts for Surgical Services – Periodontic
04-202 Gingivectomy or Gingivoplasty
04-203 Biological Materials to Aid Soft and Hard Tissue Grafting
04-204 Mucogingival Surgery and Soft Tissue Grafting
04-205 Osseous Surgery
04-206 Crown Lengthening
04-207 Gingival Flap Procedure and Apically Positioned Flap
04-301 Scaling and Root Planing
04-302 Local Delivery of Antimicrobial Agents
04-901 Periodontal Maintenance
06-002 Implant Crowns and Fixed Bridges
06-101 Implants
06-701 Abutment Crowns Fixed Partial Dentures
07-101 Removal of Teeth
07-901 Bone Grafts for Dental Surgical Services
08-001 Orthodontia - Medically Necessary Orthodontia Care
08-002 Orthodontia - Non-Medically Necessary Orthodontia Care
09-201 IV Inhalation and Local Anesthesia
Clinical Policy - 01 Teeth With A Guarded or Poor Prognosis
Clinical Policy - 02 Accidental Dental Injury
 
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Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.