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TEXAS PROVIDERS

The Network for Quality Dental Care in Texas

DentaQuest is a leading dental insurance provider in Texas, providing dental coverage to eligible members of various Medicaid, CHIP and Medicare Advantage plans. We have built a national oral health ecosystem committed to quality patient care, efficient processes and continuous improvement on the fundamentals to help your practice perform at its best.

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Dental provider during a teeth cleaning session

Serving Patients Across Texas

Texas dental providers enrolled in the DentaQuest network serve members of the following health plans and government programs in Texas.

  • Aetna Medicaid
  • Blue Cross Blue Shield
  • Community First STAR+PLUS
  • DCHP CHIP Perinate
  • DCHP STAR Medicaid
  • Driscoll Health Plan
  • Molina Medicaid
  • Molina STAR
  • Molina Star Plus
  • Molina STAR PLUS IDD
  • Molina STAR PLUS Nursing Facility
  • Superior STAR
  • Superior STAR PLUS
  • Superior STAR PLUS IDD
  • Superior STAR PLUS Nursing Facility
  • Wellpoint
  • CHIP Children Dental Services
  • Medicaid Children Dental Services
  • Superior STAR Health
  • Dental Care Plus Group HMO
  • Dental Care Plus Group PPO
  • TX Personal Dental Plan - PPO - EPO
  • DentaQuest Marketplace PPO Family High
  • DentaQuest Marketplace PPO Family Low
  • DentaQuest Marketplace PPO Pediatric High
  • DentaTrust
  • Care N Care TX
  • Molina Medicare Choice Care (HMO)
  • Molina Medicare Choice Care Select (HMO)
  • Molina Medicare Complete Care (HMO D-SNP)
  • Molina MMP
  • Superior MMP

Pretitle

Important Plan Information (Variation)

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TRAINING AND EDUCATION

Stay up to date and keep your dental practice and patients safe with the latest training.

LIVE TRAINING SCHEDULE

Important Documents and Links

Additional documents, including Office Reference Manuals, can be found on the Provider Web Portal.


 

Texas HHSC Provider Notices

To Providers: Please update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs.  To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access Provider Enrollment on the Portal - A Step-by-Step Guide

For instructions on how to make other demographic updates to your current enrollment, please access the Provider Information Management System (PIMS) User Guide.

Otherwise, you can contact TMHP directly at 800-925-9126 for assistance. 

Learn how to submit a complaint as a Medicaid Provider.

DentaQuest, a market leader in preventive strategies and improving oral health, has added Silver Diamine Fluoride (SDF), effective September 1, 2020, as an extra benefit to Texas Medicaid and CHIP dental members as part of our value-added service offerings. Silver Diamine Fluoride (SDF) provides a painless, non-invasive, efficient treatment for caries arrest, prevention and dental hypersensitivity.

 

For more information on the Medicaid and CHIP Vendor Drug Program, please visit their site at: https://www.txvendordrug.com/

To access the Medicaid formulary and Preferred Drug List (PDL) on HHSC’s website, please visit the following link: https://www.txvendordrug.com/formulary

DentaQuest encourages dental providers to participate in cultural competency training. 

DentaQuest places great emphasis on the wellness of its Members. A large part of quality health care delivery is treating the whole patient and not just the medical condition. Competency to differing cultural influences, beliefs and backgrounds, can improve a Provider’s relationship with Members and in the long run the health and wellness of the Members themselves. Read more.

Find important notices including:

  • Claim Reminders - Billing/Rendering
  • Anesthesia Prior Authorization Process Effective July 1, 2017
  • Texas Administrative Code (TAC) – Records and Sedation Requirements

 

DentaQuest Provider Notices

Provider Portal Resources

New Provider Portal Registration

Our provider portal offers a variety of resources to make day-to-day functionality easy and effective. Our enhanced interface includes an intuitive landing page customized task starters. These task starters provide access to key functions including claims processing and checking member eligibility. Important notifications will display on the landing page, and live chat will be available for quick answers to questions.

Visit provideraccess.dentaquest.com to register.

Forgot Your Password?

Follow these easy steps to reset your password.

  1. Visit provideraccess.dentaquest.com and click on "I forgot my password"
  2. If a user forgets their password, they will be asked to enter their Username & click Submit. Enter your previously set security answers. If you do not know your security questions/answers, select "I forgot the answers to my security questions" to proceed
  3. Create a new password to complete the forgot password flow
     

Helpful Tips:

  • If your account is locked due to multiple failed login attempts, wait 30 minutes to try to login again, or contact customer service for further assistance
  • 2 of your 3 security questions will be presented - you must be able to answer the questions to proceed with the forgot password reset
  • Passwords must be at least 10 characters and include at least 1 uppercase, 1 non-alphanumeric and 1 number

Get Paid Faster with Direct Deposit

Electronic Funds Transfer (EFT) which is commonly referred to as direct deposit, is the fastest, easiest and safest way to receive your claim payments. After a claim is successfully submitted, funds will be deposited within 3 business days. Your remittance will be available online in the Provider Web Portal and no longer mailed to you.

How to Enroll

  1. Log in to the provider portal provideraccess.dentaquest.com
  2. Not registered? Register here
  3. From the main menu, select Manage Practice → EFT. Fill out the form, upload a copy of a voided check with your banking information and submit.

You will receive a confirmation notification with a Request Number after successfully completing the form. Please allow up to five business days for processing.

Preventistry Pulse

PREVENTISTRY PULSE

The newsletter designed for anyone who wants to improve oral health for themselves, their families, customers or communities.