Serving Patients Across Texas
Texas dental providers enrolled in the DentaQuest network serve members of the following health plans and government programs in Texas.
Contact Us
Have a question or need to get in touch with us? Fill out our email form.
Contact your Provider Relations Representative. If you are not sure who to call, visit our Provider Relations Contacts page.
Have a complaint or need to file a pre service or claims appeal? You can reach us by:
- Phone: (800) 896-2374
- Fax: (262) 834-3452
- Online: providers.dentaquest.com
- You can also reach the Texas Department of Health and Human Services Commission at: HPM_Complaints@hhsc.state.tx.us
SCAN Medicare Advantage: (877) 227-1625
TRAINING AND EDUCATION
Stay up to date and keep your dental practice and patients safe with the latest training.
LIVE TRAINING SCHEDULE
No current trainings. Check back soon.
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.
The TMHP Provider Enrollment webpage can be accessed at the following URL: https://www.tmhp.com/topics/provider-enrollment
To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the Provider Enrollment and Management System (PEMS) web page at the following URL: https://secure.tmhp.com/pems
The "Step-by-Step Guide" can be accessed at the following URL: Provider Enrollment on the Portal - A Step-by-Step Guide.
- This page includes step-by-step instructions for maintenance requests as well as new enrollment, existing enrollment, revalidation, and reenrollment. Select the link under Existing Enrollment to access instructions for adding new practice locations or to submit a change of ownership. Select the link under Maintenance to access instructions for updating demographic data.
- This page also provides links to the Enrollment Help page and the TMHP YouTube channel.
- The TMHP YouTube channel has a playlist dedicated to PEMS. The playlist can be accessed here: https://youtube.com/playlist?list=PLIe60BLvrbETbsHtKqwWrcvMmJ_6MH9n- &si=zHCYzyE5iqBYh7kR
- Additional provider enrollment help can be found here: https://www.tmhp.com/topics/provider-enrollment/provider-enrollment-help
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.
- Texas Medicaid Healthcare Partnership
- Texas Health and Human Services
- Texas Health Steps Provider Information
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
View the Office Reference Manual (ORM) changelog for the latest ORM changes and view the latest notifications from the Provider Engagement team.
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
Follow these important steps when prior authorization is required.
Provider Portal Resources
Our Provider Portal offers a variety of resources to make day-to-day functionality easy and effective. Our enhanced interface includes an intuitive dashboard with real-time access to member eligibility, benefits, claim status, and coverage estimates, along with streamlined search capabilities that help providers quickly find information.
Ready to register?
- Navigate to providers.dentaquest.com.
- Click "Get started" from the Ready to register dialog box.
- If you are a practice administrator, click "Continue".
- Third-party administrators should click "register here" and then follow the instructions for creating their account.
- Enter your name, a username and email, then submit to receive a verification email.
- Once you receive the email, click "Verify your email".
- Set up your password, request TIN access and verify your business ID to complete the registration process.
Forgot Your Password?
Follow these easy steps to reset your password.
- Visit providers.dentaquest.com and click on "Forgot password"
- Enter your username on the Reset your password page.
- Check your email for the password reset email from Okta. Click the "Reset password" link in the email.
- Enter your new password in the New Password field and then re-enter your password in the Re-enter password field.
- When your password is accepted, you will be returned to the Login/registration page to sign in to your account using your new password.
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: Click here to access the EFT form. Print out the form and fill it out and submit per the instructions on page 2 of the form.
Provider Advisory Committee
Philosophy: DentaQuest is committed to a close partnership with the Providers in our network to ensure a successful program that allows Providers to easily render care to Members. Our goal is to ensure that Providers are given the tools to not only address critical dental needs quickly but also receive the support and reimbursement for their work. As part of our mission to improve oral health in Texas, we have formed a Provider Advisory Committee to identify program needs and challenges, advice on ways to address them, and proactively address concerns for oral health in the state.
Committee Mission : To provide DentaQuest with feedback and insight into:
- The overall view of DentaQuest in the state
- How the program is running
- Improvements that can be made to the administration of the program
- Identifying benefits that need review/change
- Suggest additional outreach possibilities for overall oral health
- Member education topics
Newsletters & Insights
Stay up to date with the latest DentaQuest and related oral care news.
Oral Health News & Resources
News Release
DentaQuest, part of Sun Life U.S., donates $100,000 to Healthfirst Foundation to support access to dental care for underserved communities
Sponsorship is funding grants to New York-based dental schools and professional associations
News Release
Sun Life U.S. names Tony Mollica as new dental business leader
Former Humana executive to lead all of Sun Life U.S. Dental, focused on growth and promoting improved oral health for all
News Release
DentaQuest’s Chief Dental Officer Named to TeamSmile Board of Directors
Dr. Todd Gray’s passion for oral healthcare aligns with Sun Life and TeamSmile missions to provide children in need with life-changing dental care
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PREVENTISTRY PULSE
The newsletter designed for anyone who wants to improve oral health for themselves, their families, customers or communities.