Working in DentalXChange
You can submit dental predeterminations and dental claims for patients with Author by Humana through the DentalXChange ClaimConnect portal. ClaimConnect is a real-time environment that validates and processes claims as they are submitted for quick and convenient claims processing.
Join Careington Maximum Care PPO Dental Network
Patients on Humana Medicare Advantage plans with service from Author by Humana access Careington’s Maximum Care PPO Dental Network which includes the subnetwork Dentemax. To provide in-network care for patients with service from Author by Humana, verify Careington Maximum Care PPO network status or contact Careington to explore joining.
1-800-441-0380, Option 6
If a procedure will cost more than $300, we recommend you submit a treatment plan for review. This should include:
A list of the services you plan to provide, using ADA nomenclature,
A written description of the proposed treatment,
Supporting pre-treatment X-Rays,
Itemized cost of the proposed treatment, and
Any other requested diagnostic materials
Claims Submission & Payment
Dental Claims payments will be delivered via paper check. Electronic payments from Author by Humana are not available at this time.
Electronic Submission Options:
Electronic Data Interchange
Payer ID: 73289
PO Box 253
Sidney, NE 69162
Please Note: If a claim is identified as overpaid, Author by Humana may send a written notice of overpayment within the applicable timeframe. Author by Humana follows state regulations, provider contract requirements, and CMS provisions when processing overpayments and recoupments. For more information, contact our Provider Navigators.
All Grievances & Dental Appeals
Participating providers may appeal on the patient’s behalf using the Dental Appeal Form linked below. Non-participating providers may appeal on behalf of themselves or on behalf of the patient, accompanied by a Waiver of Liability Form or Appointment of Representative Form.
Author Grievances & Appeals
PO Box 273
Sidney, NE 69162
Please 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.
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. I can access in-network dental care through the Careington Maximum Care PPO Dental Network."How to Use the Find a Dentist Tool, pdf opens new tab