Our insured members always have a choice in selecting their own network provider.
However, choosing a network provider in the Ameritas dental network where available may result in the member receiving reduced out-of-pocket costs. Some plans offer higher benefit percentages, increased maximums, and reduced deductibles or copayments when treatment is performed by a network provider.
Therefore, we recommend that you and your patient contact us if you are unsure about how the choice of a network provider may impact benefits. For a description of the member's plan, verify his or her benefit information: Verify Patient Benefits Verify Patient Benefits (NY)
The online provider directory on this website includes access to the names and locations of participating providers in the Ameritas PPO network. Depending on the plan, your status may impact your charges and/or your patients' benefits.
Our insured members are not required to receive approval or obtain a referral from us to see a provider. Members are welcome to seek treatment from any provider of their choice.
If possible, we suggest you refer the member to an Ameritas participating provider to help the patient maximize his or her benefits. Some plans offer higher benefit percentages, increased maximums and reduced deductibles or copayments when treatment is performed by a participating provider.
Use our online provider directory to access our online list of participating providers. You may search for general dentists or for a specific type of specialist.
Call 800-487-5553 Press 1 for dental Press 2 for providers Enter the plan member's identification number Select 6 and enter your fax number
Submit a pretreatment estimate. We recommend that a pretreatment estimate be submitted for all anticipated work that is considered to be expensive by our insured members. For more information, visit How to Submit a Claim or Pretreatment Estimate.
Ask the insured member to bring you his or her certificate, which outlines plan benefits and limitations. For Scheduled Plans, the member's certificate includes a list of the plan's maximum allowances.
Pretreatment estimates are the best way to determine a member's out-of-pocket expense. We recommend submitting pretreatment estimates for all anticipated work that is considered to be expensive by our insured members.
A pretreatment estimate is not a preauthorization or guarantee of payment or eligibility; rather it is an indication of the estimated benefits available if the described procedures are performed.
No. You will be reimbursed according to the contract fees in your area and for your specialty type. There are no monthly eligibility rosters or a referral process. This is a program that you will be able to integrate into your practice with ease.
You will be paid in accordance with the contract fees and the patient’s benefit plan. Depending on the patient’s benefits and the services provided, your reimbursement may be from Ameritas, the patient or a combination of both.
A member always has a choice in selecting their own dental provider. However, by choosing a network provider, they can help curb rising benefit costs while saving out-of-pocket expenses. Many insured members choose a network provider for these reasons.
We suggest you refer the member to an Ameritas network specialist, if possible, to help the patient maximize their benefits. You do not need to receive approval from Ameritas to refer a patient to a specialist. To obtain a list of network specialists in your area, visit our online provider directory.
No. Ameritas’ in-house Provider Relations Department is responsible for credentialing each application received. A provider will be added to the dental network once all credentialing and quality assurance requirements are successfully completed.
If you are considering participation on the Ameritas network, you may contact the Provider Relations Department at 800-755-8844, ext. 88327. Once you are an active network provider, current fee schedules are available online.
Ameritas offers several discounts on items that may be beneficial to your dental practice. Our reward programs provide savings on spore testing, dental software, eye protection and much more. View the Reward Programs available when you join the Ameritas network.
Dentist shall remain solely responsible for the quality of dental services provided and appropriate care to the Covered Person. Dentist understands and agrees that no financial incentive program exists that compensates Dentist for ordering or providing less than medically necessary and appropriate care to his/her patients. Dentist shall also provide or arrange call coverage or other back-up for twenty-four (24) hours per day, seven days per week during vacations and/or other periods his/her office might normally be closed, or make other arrangements for such coverages at Dentist’s expense. Dentist shall offer appointments to all Covered Persons upon request within a reasonable time. For non-emergency appointments other than exam, cleaning, and/or x-ray(s), a reasonable amount of time shall not be more than thirty (30) days, unless state laws and regulations require that routine appointments for non-emergency care shall be available within a different specified time frame.
Your office will need to have a system that is linked to a clearinghouse with software or internet access.
All electronic claims must be submitted through a clearinghouse.
Be sure to submit electronic claims under the same tax identification number that you would use on a paper claim. If you change this number with the IRS, please be sure to notify Ameritas of these changes.
To ensure that your electronic claim is processed properly, please be sure to include the following information:
Name of the "treating" dentist
Tax Identification Number (or the dentist's identification Number)
Office address where services were performed
It is imperative that you include the above information even if you submit under a "corporate business name."
Submit ALL claims electronically even if you think a claim needs an attachment. Ameritas will let you know if additional information is needed. Many claims can be processed utilizing the narrative or claim remark field to provide replacement dates or pocket depths. Ameritas will accept up to 250 characters in this field.
If you are having problems setting up your electronic claims capabilities or sending electronic claims, please contact your clearinghouse, vendor or billing service first. They can review your daily reports to identify any transmission errors and let you know if further research is needed.
You may also contact us at 800-659-2223, ext. 2217.
This information is provided by Ameritas®, which is a marketing name for subsidiaries of Ameritas Mutual Holding Company, including, but not limited to: Ameritas Life Insurance Corp., 5900 O Street, Lincoln, Nebraska 68510; Ameritas Life Insurance Corp. of New York, (licensed in New York) 1350 Broadway, Suite 2201, New York, New York 10018; and Ameritas Investment Corp., member FINRA/SIPC. Each company is solely responsible for its own financial condition and contractual obligations.
Ameritas® does not provide tax or legal advice. Please consult your tax advisor or attorney regarding your situation.