> ## Documentation Index
> Fetch the complete documentation index at: https://dso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Payer enrollment & submission links

> Where to enroll with the dental payer set: the federal and shared systems, each carrier's provider enrollment page, the Medicaid dental benefit administrators, and the state Medicaid index.

This index links to provider enrollment, credentialing, and EDI/ERA/EFT resources for dental payers. Report broken links to [contact@getlemma.com](mailto:contact@getlemma.com).

Payer portals, forms, IDs, and procedures change frequently. **Timely-filing limits and other participation terms come from the applicable current payer materials and your executed agreement.** Use this page as a starting point, then verify the product, entity, provider, location, and effective date with the payer.

## Start here: the federal and shared systems

| System           | Purpose                                                                                                               | Link                                                        |
| ---------------- | --------------------------------------------------------------------------------------------------------------------- | ----------------------------------------------------------- |
| **NPPES**        | Apply for and maintain NPIs (Type 1 and Type 2)                                                                       | [nppes.cms.hhs.gov](https://nppes.cms.hhs.gov/)             |
| **NPI Registry** | Look up an existing NPI, **check before creating a duplicate**                                                        | [npiregistry.cms.hhs.gov](https://npiregistry.cms.hhs.gov/) |
| **CAQH ProView** | Credentialing profile most commercial dental carriers pull from                                                       | [proview.caqh.org](https://proview.caqh.org/)               |
| **CAQH**         | EFT/ERA enrollment across participating payers                                                                        | [caqh.org](https://www.caqh.org/)                           |
| **PECOS**        | Medicare enrollment; only if you bill crossover work: oral surgery, sleep appliances, "inextricably linked" scenarios | [pecos.cms.hhs.gov](https://pecos.cms.hhs.gov/)             |
| **OIG LEIE**     | Exclusion screening, **monthly**                                                                                      | [exclusions.oig.hhs.gov](https://exclusions.oig.hhs.gov/)   |
| **SAM.gov**      | Federal debarment screening                                                                                           | [sam.gov](https://sam.gov/)                                 |

## The order of operations

<Steps>
  <Step title="NPPES">
    Type 2 NPI for the PC (requires the EIN); confirm each dentist's existing Type 1.
  </Step>

  <Step title="CAQH">
    Build or update the profile, upload documents, **authorize every target payer**, attest.
  </Step>

  <Step title="State Medicaid, if you take it">
    Agency enrollment, **plus every dental benefit administrator (DBA)** in your service area.
  </Step>

  <Step title="Commercial dental carriers">
    Contract, then credential, then EDI/ERA/EFT. Delta first in most markets, and per state.
  </Step>

  <Step title="Medicare, only for crossover work">
    PECOS 855 forms, and DMEPOS enrollment if you dispense sleep appliances. See [Enroll in Medicare](/guides/enrollment/enroll-in-medicare).
  </Step>
</Steps>

## Delta Dental: start with the member company for each state

**There is no national Delta contract.** Delta Dental is 39 independent member companies, each contracting and credentialing separately for its own service area. Enroll with **the member company for each state where a PC operates**; a ten-state group has up to ten separate Delta relationships, each with its own fee schedules, participation agreement, and credentialing platform (some member companies use DDS Enroll, others DentalXChange, others their own process).

Start at the [Delta Dental join page](https://www.deltadental.com/dentist/join-our-network/), which routes by state. Decide **per network** as well: Premier and PPO are separate participation decisions with different fee schedules. See the [Delta Dental profile](/reference/payers/profiles/delta-dental).

## Commercial dental carriers

| Payer                       | Enrollment                                                                                                          | Notes                                                        |
| --------------------------- | ------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------ |
| **MetLife**                 | [metlifedentalprovider.com/enrollment](https://www.metlifedentalprovider.com/enrollment/)                           | Credentialing runs on the SKYGEN Dental Hub since April 2025 |
| **Cigna Dental**            | [cigna.com credentialing](https://www.cigna.com/health-care-providers/credentialing)                                | CAQH-based; maintains a dedicated DSO credentialing channel  |
| **Aetna Dental**            | [aetnadental.com](https://www.aetnadental.com/professionals/join-aetna-dental-network/apply-for-participation.html) | CAQH ProView application; separate from Aetna medical        |
| **Guardian**                | [guardianlife.com/dental](https://www.guardianlife.com/dental-insurance)                                            | DPPO and DHMO; owns Avesis                                   |
| **United Concordia**        | [unitedconcordia.com](https://www.unitedconcordia.com/)                                                             | Also the TRICARE dental administrator (below)                |
| **UnitedHealthcare Dental** | [uhcdental.com join page](https://www.uhcdental.com/dental/dental-join-our-network.html)                            | Separate from UHC medical                                    |
| **Humana Dental**           | [provider.humana.com](https://provider.humana.com/dentist-resources/join-dental-network)                            | Weighted toward Medicare Advantage dental                    |
| **Ameritas**                | [ameritas.com](https://www.ameritas.com/dental-providers/join-our-dental-network/)                                  | In-house credentialing, \~15–20 business days                |

Dental credentialing is **separate from medical, even at the same brand**; a carrier's medical network confers no dental participation.

## Medicaid dental benefit administrators

State agency enrollment may not complete every required step. Depending on the state's delivery model, a provider may also need a plan or administrator contract, credentialing, affiliation, or transaction enrollment. Assignments change at reprocurement, so verify the current process on the state's Medicaid dental program page.

| Administrator           | Where                                                                                                                                          |
| ----------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------- |
| **DentaQuest**          | [dentaquest.com](https://www.dentaquest.com/)                                                                                                  |
| **MCNA Dental**         | [mcna.net](https://www.mcna.net/)                                                                                                              |
| **Liberty Dental Plan** | [libertydentalplan.com](https://www.libertydentalplan.com/about/programs-plans)                                                                |
| **SKYGEN**              | [skygenusa.com](https://www.skygenusa.com/); also runs the multi-payer [Dental Hub](https://www.skygenusa.com/dentalhub) credentialing utility |
| **Avesis**              | [myavesis.com/providers](https://myavesis.com/providers/); typically a subcontractor to medical MCOs                                           |

## Government programs

| Program                       | Where                                                                                                                                                      |
| ----------------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Medicaid FFS**              | Your state agency's provider portal, see below                                                                                                             |
| **TRICARE dental**            | Administered by [United Concordia](https://www.unitedconcordia.com/); separate from TRICARE's medical regions                                              |
| **Medicare** (crossover only) | [PECOS](https://pecos.cms.hhs.gov/); check revalidation dates at the [Medicare Revalidation Lookup](https://data.cms.gov/tools/medicare-revalidation-list) |

## State Medicaid index

Each state runs its own enrollment portal. The reliable route:

<Steps>
  <Step title="Start at Medicaid.gov's state overview">
    [medicaid.gov/state-overviews](https://www.medicaid.gov/state-overviews/index.html) links to each state agency.
  </Step>

  <Step title="Find the state's provider enrollment portal">
    Terminology varies by state and may appear as "provider enrollment," "provider services," or a vendor-branded portal.
  </Step>

  <Step title="Identify every dental plan in your service area">
    A state with FFS plus two dental administrators may require several separate steps, each with its own portal, fee schedule, and preauthorization rules. See [Enroll in state Medicaid](/guides/enrollment/enroll-in-medicaid).
  </Step>
</Steps>

## Clearinghouse payer lists: the current source for IDs

| Clearinghouse             | Payer list                                                                           |
| ------------------------- | ------------------------------------------------------------------------------------ |
| **Stedi**                 | [stedi.com/healthcare/network](https://www.stedi.com/healthcare/network), searchable |
| Optum / Change Healthcare | Via their provider resources                                                         |
| Availity                  | Via the Availity portal                                                              |
| Waystar                   | Via their payer list                                                                 |

**Payer IDs are clearinghouse-specific.** Always use **your** clearinghouse's list, and confirm the dental (837D) payer ID rather than assuming the medical one carries over.

## What to record per payer per entity

Maintain in your enrollment grid:

| Field                                                             |
| ----------------------------------------------------------------- |
| Entity, Tax ID, group NPI                                         |
| Payer name and **payer ID at your clearinghouse**                 |
| For Delta: **member company and networks** (Premier / PPO / both) |
| Contract effective date                                           |
| Provider effective date, per dentist                              |
| **Timely filing limit**                                           |
| **Appeal deadline**                                               |
| EDI status · ERA status and receiver · EFT status and account     |
| Provider relations contact                                        |
| Recredentialing / revalidation due date                           |
| Portal URL and credentials location                               |