Policies are located on the Select Health provider policies page. Click here to access now.

Any charges paid for preventive services are applied to the member’s annual maximum. Some exceptions may apply; please contact Select Health Member Services for details.

If we make payment on a code that helps to meet the member’s annual maximum, our payment (in addition to member responsibility) should not exceed the contractual allowed amount. Members are responsible for the full cost of all services received after their annual maximum is met.

The Select Health Payer ID may vary due to a variety of factors. For information regarding the Select Health payer ID, contact Member Services.

Generally, we coordinate benefits according to the coordination of benefits (COB) type for the member’s medical plan. Some exceptions may apply; contact Member Services at 800-538-5038 for details.

Send claims, appeals, notes, and other essential claim information to:
Select Health, P.O. Box 30192, Salt Lake City, UT 84130

Select Health contracted dental practices can access the Provider Benefit Tool (PBT), which lets providers and staff/proxies:

• Search for benefits and eligibility information by Select Health member ID number, Medicaid ID number, name and date of birth, or Social Security number.
• View a member’s dental coverage and claims history as well as their status or processing information by individual claim or member rather than wading through an entire remittance advice (search via subscriber ID, claim number, or member name/date of birth).
• View Dental Member Payment Summaries (DPSs), which provide more benefit details, such as frequencies, limitations, and exclusions. NOTE: Not all dental DPSs are the same; contact Member Services with questions.
• Attach supporting documents to a specific dental claim (when required) to facilitate reprocessing.
• Quickly locate deductible and out-of-pocket accumulators or search for provider claims by date of service or within a given date range.
• If applicable, view coordination of benefits information to help determine the order of benefits for a member.

No, Select Health does not require downgrades.

Select Health only requires the prep date to be reported.

No, occlusal guards are not covered on any Select Health Dental plan (even if billed under D9944, D9945, or D9946).

Only the preparation date should be reported for dental crowns.

For group plans, these services will be administered as either major or basic benefits, depending on how the employer group has defined their benefits. For Individual plans, these services are covered under the major benefits. Please refer to the member’s Dental Payment Summary (DPS) for more details. NOTE: Dental providers must be appropriately credentialed to perform anesthesia.

An FMX is defined as 14 or more PA X-rays/ bitewings.

General anesthesia and IV sedation are considered dentally necessary and are covered under dental benefits when performed in conjunction with one or more of these covered dental procedures or circumstances:

• Removal of a full and/or partial bony impacted tooth or teeth
• Surgical extraction of 3 or more teeth performed on the same day
• Full edentulous arch alveoloplasty or alveolectomy
• One or more quadrants of periodontal (osseous) surgery performed on the same day
• Surgical exposure of bone impacted or unerupted cuspids (i.e., impacted bicuspid or canine teeth)
• Placement of one or more implants
• A child younger than 7 with a dental condition of significant complexity