Avesis Third Party Administrators, Inc. has partnered with UPMC Health Plan, to administer the delivery of dental services to members of UPMC for You, UPMC for Life, UPMC for Life Specialty Plan, UPMC for Life Options, UPMC for You Advantage, UPMC for Kids and FEHB starting January 1, 2010. Your participation will allow you to deliver dental services to the members of these UPMC Plans.
This new partnership is effective January 1, 2010. Avesis will be paying claims for covered services provided to eligible members of the Plans noted below.
About the Programs
- UPMC for You, affiliate program of UPMC Health Plan, offers affordable dental care to eligible Medical Assistance recipients in the UPMC Health Plan service area.
- UPMC for Kids is available through a contract with the Childrens Health Insurance Program (CHIP) of Pennsylvania. CHIP is a State and Federally funded program to provide health insurance for uninsured children from birth until they reach the age of 19. In 2007, Pennsylvania CHIP was expanded to offer health insurance to children and teens who are not eligible for Medical Assistance, regardless of family income. Enrollment eligibility is evaluated every 12 months.
- UPMC for Life HMO and PPO offer choices for more enhanced services and care options than are available through traditional Medicare, including routine dental services.
- UPMC for Life Options Plan offers dual eligible members (Medicaid/Medicare) choices for more enhanced dental services and care options that are available through traditional Medicare, including routine dental services.
- UPMC for You Advantage Plan offers dual eligible members (Medicaid/Medicare) choices for more enhanced dental services and care options that are available through traditional Medicare, including routine dental services.
- UPMC Community Care Plan offers dual eligible members (Medicaid/Medicare) choices for more enhanced dental services and care options that are available through traditional Medicare, including routine dental services.
- Federal & Postal Employee Health Benefits (FEHB) Plan offers two levels of limited dental coverage to enrolled members. The first level includes routine, diagnostic, and preventive services that are provided at no cost to the member. The second level lists all of the other covered services and the corresponding fee due from the member according to standing office policies. Procedures not listed are the responsibility of the member.
Join the Avesis Provider Network
Please complete the Provider Practice Application in its entirety and sign the Provider Agreement. All of the information should be mailed mailed to Avesis at the address below. If you have any questions, please contact a Provider Services Representative at 888-209-1243.
If you need to obtain a PROMISe ™ ID number please visit the following website http://www.dpw.state.pa.us/provider/promise/enrollmentinformation/index.htm
Send completed materials by mail to Dental Provider Credentialing
Mail To:
Avesis Third Party Administrators, Inc.
Attn: Dental Credentialing
10324 S. Dolfield Road
Owings Mills, MD 21117
Phone:
888-209-1243