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.
EmblemHealth Medicare providers are required to complete the Special Needs Plan (SNP) Model of Care training for each of the Dual Eligible SNPs in which they participate, as mandated by the Centers for Medicare & Medicaid Services (CMS). Providers who do not complete the training may be removed from the Emblem Health Provider Directory.
Important Information about EmblemHealth!
DentaQuest is please to begin a new partnership with EmblemHealth to provide state-of-the-art dental care to NY residents beginning January 1st 2017. To support this partnership, DentaQuest has launched a new and improved dental provider portal that features enhanced functionality, improved user interfaces, and innovative tools to support providers in serving EmblemHealth members. Please note: All other New York health plans (Affinity, Fidelis, Healthfirst, etc.) will continue to be supported by DentaQuest’s legacy portal, with anticipated transition later in 2017. Please see the how to register link below to register for the new provider portal for EmblemHealth plans.
Important Information about EmblemHealth:
- EmblemHealth Office Reference Manual
- EmblemHealth Provider Training Slides
- EmblemHealth Transition of Care Information for In-Network Providers
- EmblemHealth Transition of Care Information for Out-of-Network Providers
- EmblemHealth FAQs
- How to verify EmblemHealth member eligibility
- Once registered on the portal you can check eligibility by simply clicking on “Patient Management” on the left hand margin, and then click on “Member Eligibility.”
- IVR (interactive voice response) is also available 24 hours a day, 7 days a week without having to wait for a live Customer Service Representative!
- Important information on submitting claims and authorizations for EmblemHealth Members:
- Once registered on the portal you can submit Emblem claims and Emblem pre-authorizations by clicking on “Claims/Pre-Authorizations” on the left hand margin.
- If you submit your claims on an ADA Dental Claim form via mail, the address for Emblem claims only is:
- Emblem Dental (DentaQuest)
PO Box 463
Milwaukee, Wisconsin 53201
Fax Claims to: 262.834.3589
- If you submit your claims through a clearinghouse 837D file it is critical that you have your clearinghouse update the Payer ID for Emblem claims. The Payer ID is: EMBDQ. If your software does not allow for a Payer ID please use Payer Name: DQ/Emblem. This is different from all other DentaQuest administered plans. If you do not use the correct Payer ID, your claims may be routed incorrectly and denied. Your office will receive a letter indicating “Member Not Found.”
Important Information about DentaQuest’s New Provider Portal
Communication Library (Coming Soon!)
Join Our Network:
DentaQuest has a NEW and improved Online Enrollment and Credentialing Tool!
Learn how to use this new tool (and more) by attending one of our scheduled WebEx trainings. Please click here
to access the training schedule.
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 call your provider relations representative.
CAQH Sign Up
Additional Provider Documents: