Welcome, DentaQuest Dentist

We respect the contributions of our providers. By providing you with advanced technological tools, we eliminate the administrative burden associated with participating in government-sponsored programs.  Beyond representing an act of public service in your community, we want your participation in our network to represent a sound business decision. 
 

Important Indiana Dental Care Plus Information:


Important Information about Healthy Indiana Plan, Hoosier Care Connect and Hoosier Healthwise programs:

DentaQuest has partnered with two Managed Care Entities (MCEs) in Indiana to administer the state's Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier Healthwise programs. Anthem Blue Cross and Blue Shield (Anthem) has chosen DentaQuest to administer the HIP, Hoosier Care Connect and Hoosier Healthwise dental benefits.  MDwise has chosen DentaQuest to administer the HIP and Hoosier Healthwise dental benefits.  
 
DentaQuest encourages providers to Enroll Online or click HERE to submit your CAQH information. You can also contact one of our recruiters at 1-855-873-1283 to obtain a paper application to participate in the DentaQuest network.

Once you are enrolled as a DentaQuest provider, you will be able to access the DentaQuest secure provider web portal to submit claims and prior authorization requests, check member eligibility, and review claims status.
 
HIP and Hoosier Care Connect Network:
  • The HIP and Hoosier Care Connect networks will remain open until they have been deemed fully complaint by the state of Indiana. We encourage you to complete the contracting and credentialing process immediately to ensure you and your staff are enrolled and credentialed.
Authorization Grace Period
  • Hoosier Care Connect Grace Period: DentaQuest will honor all services approved by IHCP for 90 days following a members movement into Managed care or between Managed care plans. After the 90 day transitional period closes, DentaQuest will not honor services approved by IHCP that have not yet been rendered. This will create a sliding scale based upon individual member’s movements into Managed care.

Hoosier Healthwise Coordination of Care:

  • DentaQuest will honor all previous care authorizations from the member’s enrollment in the Hoosier Healthwise program from a previous health plan. From January 1, 2017, through March 31, 2017, DentaQuest will accept previous authorizations from the newly eligible member’s previous health plan for 90 calendar days. As of April 1, 2017, DentaQuest will accept previous authorizations from the newly eligible member’s previous health plan for 30 calendar days. Contracted or non-contracted IHCP providers should submit the previous care authorization as an attachment with the claim.
 

Provider Resources:

HIP, Hoosier Care Connect, and Hoosier Healthwise Office Reference Manual
Indiana Hoosier Healthwise Quick Reference Guide

IHCP HIP 2.0 Announcement
: Please click here to access IHCP's HIP 2.0 announcement. Scroll to pages 4-5 for information on dental services and how to contact/ submit claims to DentaQuest!
 
Information about HIP: Please visit the FSSA Indiana HIP website for program information, FAQs, and much more!

Information about Hoosier Care Connect: Please visit the FSSA Indiana Hoosier Care Connect Website for program information.

Information about Hoosier Healthwise: Effective January 1, 2017, DentaQuest will be administering dental benefits for Anthem and MDwise. This program covers children up to the age 19, pregnant women and low income parents/ caretakers of children under the age of 18. Please visit the Hoosier Healthwise website for additional information.  
 
Indiana Medicaid Fee Schedule:  Covered services rendered to the HIP members will be reimbursed at 130% of the current Hoosier Healthwise fee schedule, while Hoosier Care Connect and Hoosier Healthwise members will be reimbursed at 100% of the current Hoosier Healthwise fee schedule.  Click on this link to view the published Hoosier Healthwise Fee Schedule. Click on this link to view an illustrative rendering of the covered services and associated fees for the HIP and Hoosier Care Connect programs.  The published Hoosier Healthwise Fee Schedule is the official source of the fee schedule; in the event of a conflict shall supersede.

HIP Member Effective Date: Please click here for details.
 
To Check HIP Member Eligibility: For those providers not yet registered with DentaQuest, please continue to verify member eligibility using the IHCP Web Interchange.

HIP State Plan Basic Co-PaymentsCopayments for outpatient dental services are assessed for each category, even if they are delivered by the same provider, at the same location, on the same date.  When multiple services within one category are preformed, only one co-payment can be assessed within that category, per date of service.
 
Category: Codes: Co-Pay:
Diagnostic D0120 - D0486 $0
Preventive D1110 - D1999 $0
Fillings and other basic restoratives D2140 - D2394 $4
Major restoratives D2910 - D2990 $4
Endo D3220 - D3430 $4
Perio D4210 - D4910 $4
Dentures D5110 - D5226, D5281 $4
Prosthetic adjustments, repairs, rebase, relines D5510 - D5761, D6930, D6980 $4
Maxillofacial Prosthetics D5951 - D5993 $4
Oral Surgery D7111 - D7999 $4
Adjunctive D9110 - D9920 $4

HIP, Hoosier Care Connect and Hoosier Healthwise Periodontal Treatment Click here for Periodontal Treatment Criteria.

DentaQuest - Indiana Provider Engagement Representative Territories – Click here for details.

Provider Portal User GuideClick here for details.

DentaQuest Indiana Managed Care Overview – Click here for details.

DentaQuest Indiana Provider Newsletter Volume 1 – Click here for details.

DentaQuest Provider Smoking Cessation – Click here for details.

Authorization and Prior Authorization for D9230-Analgesia, Anxiolysis, Inhalation of Nitrous Oxide – Click here for details.

Units Increased for D9223 and D9243Click here for details

Orthodontic Authorization Checklist for Indiana Dental Providers – Click here for details

Changes to Anthem Blue Cross and Blue Shield (Anthem) Member Identification Numbers Effective April 1, 2017 – Click here for details

HIPAA Transaction Standard Companion Guide - Click here for details

 

Join Our Network:

DentaQuest has a NEW and improved Online Enrollment and Credentialing Tool! 

Enroll by Mail:

We encourage you to complete your credentialing application online.  However, we understand an online solution is not everyone’s preference. If you prefer to complete a paper application, please click here.

 

CAQH Sign Up

The Council for Affordable Quality Healthcare (CAQH) offers a single credentialing application and an online database that contains information necessary for insurance companies to credential a provider. This allows you to submit and maintain your credentialing information at one location rather than filing with many organizations. There is no cost to file an application with CAQH and it can be completed online. Click here to visit the CAQH website.