Box 931655 Atlanta, GA 31193-1655. Any service or treatment method which does not meet professionally recognized standards of dental practice or which is considered to be experimental in nature. Humana Claims If a paper claim does not have all necessary NPIs, it may be denied or be subject to delays in adjudication. This includes, but is not limited to: (1) characterization and personalization of a Dental Prosthesis; (2) bleaching of discolored teeth; and (3) odontoplasty. The new claim submission address for PPO claims is P.O. Dental plans are underwritten by Dominion Dental Services, Inc. (DDSI). For group plans, please refer to your Benefit Plan Document (Certificate of Coverage/Insurance or Summary Plan Description/Administrative Services Only) for more information on the company providing your benefits. Watch this video to learn more. Out-of-Network Dentist: Reimbursement is based on the lower of your dentist’s fees or the amount that would be paid to dentists who have agreed to be reimbursed according to Guardian’s negotiated fee schedule The in-network dentist submits all dental claim forms directly to Guardian on your behalf. “Humana” is the brand name for plans, products and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (“Humana Entities”). Treatment for which no charge is made. Keep in mind, however, that the claim or encounter mailing address on the member’s identification card is always the best to use. Atlanta, GA 31193-1655. Attn: Claims To register for the Availity Portal or to learn more about Availity claims solutions, visit Availity.com., opens new window, Waystar, a ZirMed and Navicure company, offers healthcare providers no-cost solutions for electronic claims submission. Products Underwritten by Guardian Life Insurance Company of America . Application of desensitizing medicaments and desensitizing resins for cervical and/or root surface. Overdentures and related services including root canal therapy on teeth supporting an overdenture. boxes in Spokane, Washington, will officially close on Oct. 31. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits). Guardian, its subsidiaries, agents, and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services, and make no representation as to the completeness, suitability, or quality thereof. Humana group medical plans are offered by Humana Medical Plan, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Health Plan of Ohio, Inc., Humana Health Plans of Puerto Rico, Inc. License # 00235-0008, Humana Wisconsin Health Organization Insurance Corporation, or Humana Health Plan of Texas, Inc., or insured by Humana Health Insurance Company of Florida, Inc., Humana Health Plan, Inc., Humana Health Benefit Plan of Louisiana, Inc., Humana Insurance Company, Humana Insurance Company of Kentucky, or Humana Insurance of Puerto Rico, Inc. License # 00187-0009, or administered by Humana Insurance Company or Humana Health Plan, Inc. For Arizona residents, plans are offered by Humana Health Plan, Inc. or insured by Humana Insurance Company. Pulp vitality tests or caries susceptibility tests. Any service furnished solely for cosmetic reasons. Box 14601 A process known as advanced claims editing (ACE) applies coding rules to a medical claim submitted through the Availity gateway via EDI before the claim enters Humana’s claim payment system. A fixed bridge replacing the extracted portion of a hemisected tooth or the placement of more than one unit of a crown and/or bridge, per tooth. In addition, Waystar’s auto-adjudication tool checks claims for accuracy more quickly than a manual review. Any restoration, service, Appliance or Dental Prosthesis used solely to: (1) alter vertical dimension; (2) restore or maintain occlusion; (3) treat a condition necessitated by attrition or abrasion; or (4) splint or stabilize teeth for periodontal reasons. Healthcare professionals can check the status of submitted claims on the Availity Provider Portal, Register through Availity website , opens new window, To find out more, please review Products are not available in all states. Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations and terms under which the coverage may be continued in force or discontinued. Humana individual life insurance plans are offered in New York by Humana Insurance Company. Guardian Providers Associate Acknowledgement Form Credentialing Checklist MDG Advantages MDG Dentist Profile MDG Office Profile W9 Form Specialty Referral Form Guardian PPO ADA Claim Form Premier Access Providers General Associate Application Practice & Facility Information Form W- 9: Request for TIN and Certification Provider_ Dispute_ Resolution Claim Form Emdeon ePayment … Claim overpayments: Humana P.O. Guardian will only pay a standard amount, calculated according to the requirements of your state. Contact Us I need help with a specific insurance or investment offering. Now more than ever, it’s important to ensure your claims are processed and paid as quickly as possible. DENTAL HMO PLANS FLORIDA Policy Form IP-1-MDG-DHMO-FL-OFF-17 NEW YORK Policy Form IP-MDG-NY-FP-OFF-17 Products Underwritten by Managed Dental Guard, Inc. Employer Name Premier Access Individual Dental Claims PO Box 254888 Sacramento, CA 95865-9005 Confidentiality for domestic violence victims. Guardian Direct dental insurance plans can cover regular exams, cleanings, x-rays, root canals, crowns, implants, and braces. Time frames to submit a claim For more information, visit Humana.com/provider/coronavirus. Lexington, KY 40512-4611, Humana Encounters Name (Last, First, Middle Initial, Suffix), Address, City, State, Zip Code 13. 2020-99219 (02/21) Links to external sites are provided for your convenience in locating related information and services. Healthcare professionals can check the status of a claim on the Availity Portal. DENTAL PPO PLANS Policy Form IP-DEN-16 ET. Humana’s priority during the coronavirus disease 2019 (COVID-19) outbreak is to support the safety and well-being of the patients and communities we serve.

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