February 1, 2025

February 2025 Dental Provider Newsletter

Contents

AdministrativeDentalFebruary 1, 2025

Ensure your provider directory is accurate

AdministrativeDentalFebruary 1, 2025

Consolidated Appropriations Act federal mandate

AdministrativeDentalFebruary 1, 2025

Credentialing with CAQH ProView

MULTI-BC-DEN-076724-25

AdministrativeDentalFebruary 1, 2025

Ensure your provider directory is accurate

Inaccurate provider directories create frustration for members and providers. To ensure that our members can find you, please visit our online provider directory to verify the information that we have listed for your office.

Updating your dental practice information assists us with processing your dental claims accurately and timely. We are also able to relay correct information to dental members, including your practice contact information and your location.

Notify us whenever there is a change in:

  • Location: Adding a new practice, demographic changes to an existing practice (including phone, fax, email, and address), or closing an office. Confirm with us that we have your correct billing and mailing address.
  • License: Provide the treating dentist license number as issued rather than a shortened version.
  • Tax Identification Number (TIN): Complete and submit a W‑9 form along with a letter or Tax ID change form requesting the TIN change and the effective date of the TIN change. Please provided a list of what networks the change affects. If you are unsure of your network participation, contact Professional Services by calling 866‑947-9398.
  • National Provider Identifier (NPI) – Confirm we have your individual NPI and clinic NPI. Please note this is not only for electronic claims submissions. Due to new mandates, some states require an NPI for all claims submissions!
  • Ownership change: Provide the practice name, date of purchase, and W‑9 if the TIN is not currently on file. Please include a list of dentists associated with this TIN and their participating networks.
  • Adding or removing associates: If an associate retires, leaves, or a new associate is added to your practice, contact us with the updated information.

The Standardized Provider Maintenance Form is a fillable PDF, available online. You can also contact Dental Network Professional Services to email or fax it you. To submit changes to your information in the directory, submit a General Office Information Form, located on our website, via email, fax, or mail. For multiple changes, one General Office Information Form is needed. You can also contact us at 866‑947-9398 to update information as necessary.

Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BC-DEN-076808-24-CPN75842

AdministrativeDentalFebruary 1, 2025

Consolidated Appropriations Act federal mandate

The Consolidated Appropriations Act (CAA) and state law, require us to maintain accurate provider directories. Please respond to this notification by confirming that the current information is accurate or providing updated information.

A Provider Verification Form or an email from Healthlink Dimensions with steps to complete your verification of your practice will be sent to you. Please ensure Healthlink Dimensions has been added to your trusted sender list to ensure vital communication is received.

We appreciate your due diligence in keeping us informed of any changes impacting your office.

Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BC-DEN-076809-24-CPN75842

AdministrativeDentalFebruary 1, 2025

Credentialing with CAQH ProView

We use the American Dental Association® (ADA) credentialing service, powered by the Council for Affordable Quality Healthcare, Inc. (CAQH) ProView®, the industry standard for capturing and sharing self‑reported professional and practice information. It streamlines provider data collection by using a standard electronic form that meets the needs of most dental plans, hospitals, and other healthcare organizations. Learn more by visiting ADA.org/credentialing.

Getting started

Review the dental credentialing application checklist at ADA.org/credentialing and gather required documentation prior to filling out your profile. Doing this will help first‑time users complete the profile in about an hour.

Practicing dentists can sign up for credentialing on ADA.org/godigital. Once terms and conditions are accepted, you will be redirected to the welcome page. There, you will see certain prepopulated information from the ADA making it simple to complete.

The CAQH ProView menu prompts will guide you through each step. You control which organizations receive your profile information either by authorizing all of them or specific ones, including Anthem.


Maintaining your self‑reported information

Current CAQH ProView users can access their profile at ADA.org/godigital. To ensure your profile is completed:

  • Add new documents to replace expired ones.
  • Remove work history gaps for the past five years, or list the reasons for any gaps, such as leaves of absence, maternity leaves, and illness.
  • Ensure a current copy of your liability insurance is attached to your profile.
  • If you only authorize specific organizations access to your profile, please add Anthem.


Upon completion, a confirmation email will be sent to the primary email address on your profile. You should attest to your profile every 120 days to ensure other insurers you are contracted with can access your profile to start the credentialing process.

For assistance with completing your profile call the ADA Member Service Center at 800‑621-8099 or the CAQH Help Desk at 888‑599-1771.

FAQ

  • Do I need to be an ADA member to participate?
    • No, any U.S. practicing dentist can participate.
  • Does it cost anything to use CAQH ProView?
    • There is no cost for dentists to use CAQH ProView.
  • What does it mean to attest to my data in CAQH ProView?
    • After you enter your professional and practice data, you must attest to its accuracy.
  • I recently received an email from CAQH ProView, asking me to re‑attest to my profile. What does that mean?
    • The system will notify you every 120 days to re‑attest that all information is still correct and complete or update it if not. This enables a dentist’s contracted dental plans to access CAQH ProView profile information based on their different re‑credentialing cycles. A dental plan or other participating organization with authorized access will only be able to access your data once you have completed the re‑attestation process.
  • Does this mean I need to completely revise my profile every 120 days?
    • No, you need to review and update any information that has changed, and re‑attest to its accuracy.
  • Whom can I contact for help or if I have any questions?
    •  Within CAQH ProView, click the chat icon at the top of any page to ask a question. You can also contact:
      • The ADA Member Service Center at 800‑621-8099 Monday through Friday 8:30 a.m. to 5 p.m. CT, or msc@ada.org.
      • CAQH Help Desk at 888‑599-1771, Monday through Friday 8 a.m. to 8 p.m. ET.

Dental credentialing application checklist

These items are necessary to complete your credentialing application:

  • A copy of your state license(s)
  • A copy of your professional liability insurance face sheet
  • Practice information
  • Individual National Provider Identifier (NPI) number

You may also need the following, depending on the state in which you practice:

  • Hospital affiliation information
  • A copy of your anesthesia license
  • A copy of your Drug Enforcement Administration (DEA) license
  • A copy of your Controlled Dangerous Substances (CDS) license
  • Medicare number
  • Medicaid number
  • Basic Life Support (BLS) certification information
  • Advanced Cardiovascular Life Support (ACLS) certification information

Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BC-DEN-076810-24-CPN75842