Author by Humana Medicare Advantage dental benefits are provided by the Careington Maximum Care PPO Dental Network. This page includes information that you’ll need to work with Author by Humana.
You can call our Provider Navigators at 1-833-502-20131-833-502-2013, 8 AM - 5 PM Eastern time, Monday through Friday. We’re happy to assist you with any questions about Author by Humana.
Author by Humana Dental Benefits for 2021:
American Dental Association (ADA) Codes & Benefit Frequencies by DEN Number:
Eligibility Checks & Predeterminations:
How to Verify Eligibility or Submit a Predetermination Electronically:
If a procedure will cost more than $300, we recommend you submit a treatment plan for review (predetermination). This should include:
A list of the services you plan to provide, using ADA nomenclature and codes
Your written description of the proposed treatment
Supporting pretreatment X-rays
Itemized cost of the proposed treatment
Any other diagnostic materials that Author by Humana requests
Claims Submission & Payment:
How to Submit a Claim Electronically:
Electronic Data Interchange (EDI)
Author by Humana Payer ID: 73289
Fax or mail us a Paper Claims Form
PO Box 253
Sidney, NE 69162
Payment will be delivered via paper check. Electronic payments from Author by Humana are not available at this time.
Grievances & Appeals:
How to Submit a Dental Appeal on Behalf of a Patient:
Author Grievances & Appeals
PO Box 273
Sidney, NE 69162
Call our Provider Navigators
1-833-502-20131-833-502-2013Please Note: A request for an expedited appeal can be submitted if waiting for a standard response time frame could seriously jeopardize the member's life, health, or ability to regain maximum function. Expedited appeals are not used for claims that have already been paid or denied.
Join Careington Maximum Care PPO Dental Network:
Contracting & credentialing are managed by Careington Maximum Care PPO Dental Network.
1-800-441-03801-800-441-0380, Option 6
7400 Gaylord Pkwy
Frisco, TX 75034
Important Resources for Members:
We encourage our members to state the following when they call you for an appointment:
"I have dental benefits with my Humana Medicare Advantage plan. The dental benefits are provided by the Careington Maximum Care PPO Dental Network."