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Frequently Asked Questions

What dentists may I see with my Direct Dental Plan?

You may see any dentist that you wish with your Direct Dental Plan.

If your employer has access to the Dental Health Alliance (DHA) network, then you have access to see dentists in this network at a discounted rate. Please review your plan’s Benefit Summary, or consult with your HR department to determine if you have access to the DHA network.

How can I locate a Dental Health Alliance (DHA) Provider?

Click here to search for a DHA provider near you.

What do I need to bring to my dentist to use the plan?

You will no longer need to present a physical identification card when you go to the dentist. Your provider can verify your eligibility in one of four simple ways:

  1. Your provider can contact Provider Services at 855-866-2615 to verify your eligibility.
  2. Your provider can look up your eligibility on the Direct Dental Provider Web Portal.
  3. If you would like an identification card, you may print out a card by going to the Direct Dental Member Web Portal. Direct Dental members have the convenience of a digital member identification card. You can even provide your digital member identification card on your smart phone or mobile device when you’re on the go. You must register with the portal as a member to view or print your ID card. Signing up is simple and free – it only takes three clicks!
  4. You may also bring a copy of your Plan Benefit Summary to your provider. Your Plan Benefit Summary is available to you in the Member Web Portal or from your HR team. 

How do I register with the Member Web Portal?

You can register with the Direct Dental Member Web Portal by clicking on Login on the top navigation panel, then clicking Member Web Portal.

You will be asked to enter your Subscriber ID. If you don’t know your Subscriber ID, simply enter the last four digits of your Social Security Number.

If you experience any issues with registration, contact Portal Support at 844-275-8758 and they can assist you with the registration process.

How does my provider submit and a claim and get paid?

Your provider can send your claim to Direct Dental electronically via our Provider Web Portal, via other electronic claim services including Emdeon and DentalXchange, or via fax/mail to the addresses below:

Dental Claims

Vision Claims

Direct Dental Claims Direct Dental Vision Claims
PO Box 497 PO Box 192
Milwaukee, WI 53201 Milwaukee, WI 53201
Fax: 866-849-2038 Fax: 866-849-2038

Authorizations

Appeals

Direct Dental Authorizations Direct Dental Appeals
PO Box 260 PO Box 252
Milwaukee, WI 53201 Milwaukee, WI 53201

What if I pay my provider out of pocket for services?

If you pay out of pocket for services, you can send us a Claim Reimbursement Request. Download a Claim Reimbursement Request form by clicking here.

When will I receive payment if I paid out-of-pocket for services?

You can expect to receive your reimbursement within 30 days or less of Direct Dental receiving your Claim Reimbursement Request along with clean copy of your claim receipt(s).

Please note that failure to provide appropriate documentation with your reimbursement request may result in delays in the processing of your claim.

Are all dental services covered by my Direct Dental Plan?

Your Plan Benefit Summary describes the services covered by your plan. Your Plan Benefit Summary is available to you in the Direct Dental Member Web Portal or from your HR team.

How do I coordinate benefits with another dental plan?

If you are the primary subscriber and you receive care, Direct Dental is the primary carrier, and secondary benefits are handled by your secondary carrier.

If a dependent with their own primary coverage receives care, we use the Explanation of Benefits from the dependent’s primary carrier and pay benefits against what remains from the primary carrier.

Please contact Member Services at 855-844-0626 to provide additional coverage information.

What is my remaining available balance?

The amount of your remaining available balance, as well as your claim status and history, can be found in the Direct Dental Member Web Portal under the Benefit Tab in the top navigation panel.

You may also contact Member Services at 855-844-0626 for assistance with your balance and more.

Where do I go with questions about my coverage or plan?

Please contact Member Services at 855-844-0626 or review your Direct Dental Plan Benefit Summary.

How can I contact Direct Dental Administrators?

Member Services

Provider Services

855-844-0626 855-866-2615
[email protected] [email protected]

Web Portal Support

Claims Department

844-275-8758 [email protected]

Authorizations

Appeals

[email protected] [email protected]

Direct Dental Website

DHA Provider Locator

www.directdentalplans.com www.directdentalplans.com/find-provider