Administration

Claims Processing

Providers cite claim processing as the number one reason for declining to participate in government dental programs. Our commitment to fast and accurate claims processing is integral to provider satisfaction and retention. It also ensures the network stability required to deliver appropriate access and consistency of care to our members. Our claims processing works well because of our strengths:

• DentaQuest has more than a 99% accuracy rate in claims processing. We have never missed a payment cycle. Providers can count on timely payments and easy-to-read reimbursement statements.
• DentaQuest's system adjudicates all claims automatically. It has the ability to update individual and family claim history, perform claim payment calculations, calculate and update co-payment/deductible accumulations, and track benefit maximums and frequency limits.
• DentaQuest is able to receive dental claims in a variety of formats to meet the needs of both our clients and providers. We encourage and train providers to submit claims electronically, but we can easily handle paper claims submissions as well.

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