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Dental Providers

Dental provider resources and information related to claim payments, online tools, and dental plans.

Dental claim processView member benefits

Dental Claims, Fees, and Tools

Dental Claims Process

How to submit covered dental claims electronically:

  1. Utilize clearinghouse software to submit a covered claim electronically.
    a. No additional documentation is required if submitting only covered claim codes.
  2. If claim includes possibly covered claim codes, review the next section.

How to submit possibly covered dental claims:

  1. Review the possibly covered claim code list.
  2. Dental claims that include possibly covered codes may be submitted using clearinghouse software, fax, or direct mail. Claims or possibly covered codes cannot be submitted via email at this time. 
  3. Important note to avoid delays: Any claim that includes possibly covered codes, regardless of the submission method, must include necessary documentation such as x-rays, perio charts, and/or chart notes. These documents may be mailed, emailed, or faxed (see below).

To submit dental claims by mail:

  • Print ADA claim form from clearinghouse system.
  • Include necessary documentation if submitting any possibly covered codes.

Submission information:
Electronic submissions: Use clearinghouse software
Faxed submissions: 801-442-6580

Mailed submissions:

  • Select Health Dental Claims Processing (commercial or CHIP claims)
    P.O. Box 30192 Salt Lake City, UT 84130
  • Select Health Dental Claims Processing (Medicare claims only)
    P.O. Box 30196 Salt Lake City, UT 84130
  • Note: Medicaid dental claims are not covered at this time.

Dental Fee Schedules

Select Health dental fee schedules can be obtained from the secure Provider Portal. If you need to sign up to access the portal, see the instructions below.
Dental Fee Schedules  Access Instructions


Dental Provider Tools

Network and Plans

Why join Select Health’s dental network?

There are many advantages to joining Select Health’s dental network. These include:

  • Over 170,000 members
  • 8% YoY dental membership growth
  • Competitive fee schedule
  • Local customer service and claims processing
  • Local provider relations representatives
  • Large medical membership who prefer to have medical and dental coverage combined
  • Medical Exchange plans with preventive dental coverage for both children and adults

To get started today, call Select Health provider development at 800-538-5054.

Select Health Commercial Dental Plans

Individual: 

  • Traditional plans; network-only providers
  • “Buy-up” option for non-participating providers
  • Pediatric preventive dental included

Large Employer:

  • 51+ employees
  • 3 network choices*
  • Optional orthodontics
  • Voluntary or contributory
  • Customized waiting-time options

Small Employer:

  • Traditional plans; network - only providers
  • Pediatric preventive dental included

* Classic network providers are in all Utah counties and represent the majority of dental providers in Utah. Prime and Fundamental network providers are only in Davis, Salt Lake, Weber, and Utah counties. Contact Provider Development at 800-538-5054 for more information about these networks.

Select Health Dental Advantage (Medicare) Plan

Medicare (Dental Advantage®) Plan Feature

  • Geographic-based coverage*
  • Preventive benefits provided as part of Select Health Medicare Advantage® coverage**
  • Wasatch Advanced includes comprehensive dental benefits
  • Wasatch Essential and Southwest/Central plans includes comprehensive dental benefits

* Wasatch Plans (Advanced and Essential): Available to members in Box Elder, Cache, Davis, Morgan, Rich, Salt Lake, Summit, Tooele, Utah, Wasatch, and Weber counties Southwest and Central Plans: Available to members in Garfield, Iron, Juab, Millard, Piute, Sevier, Washington, and Wayne counties.
** Dental Advantage Preventive benefits: 2 exams, 2 cleanings, and 2 full-series bite wing x-rays per calendar year; EITHER 1 panoramic OR 1 complete mouth x-ray every 36 months.

Preventive-only Dental Coverage (included in all Dental Advantage Medicare plans)

Cleanings

  • Allowable Benefit/Timeframe: 2 cleanings/calendar year
    • Applicable Codes: D1110, D1120

Oral Examinations

  • Allowable Benefit/Timeframe: 2/calendar year
    • Applicable Codes: D0120, D0145, D0150

X-Rays

  • Allowable Benefit/Timeframe: 2 full series bite-wings/calendar year
    • Applicable Codes: D0270, D0272, D0273, D0274, D0277
  • Allowable Benefit/Timeframe: 1 Panorex/36-month period in lieu of complete mouth x-ray
    • Applicable Codes: D0330
  • Allowable Benefit/Timeframe: 1 complete mouth X-ray/36-month period in lieu of Panorex
    • Applicable Codes: D0210