Sun Life Financial, US

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Dental Plan FAQ's

About our PPO Networks

  1. What Preferred Provider Organization (PPO) Networks do you offer?
  2. How will I know when a patient participates in one of your PPO networks?
  3. How do I join your PPO networks?
  4. Is there a fee to join your PPO networks?
  5. How is the quality of the network assured?
  6. How do patients find out that I am a participating dentist?
  7. May I discontinue referrals?
  8. Who do I call with questions about my network participation?
  9. Who do I call if I have questions regarding my Personal Fee Profile?
  10. Who do I contact if I have questions regarding my responsibilities with your PPO Networks?

What Preferred Provider Organization (PPO) Networks do you offer?

We offer the Assurant® Dental Network and the Assurant Focus Dental Network®. Our PPO networks include dentists contracted with Dental Health Alliance, L.L.C.® (DHA®) and dentists under access arrangements with other dental networks.

How will I know when a patient participates in one of your PPO networks?

All eligible members will receive an identification card listing their PPO network.

How do I join your PPO networks?

To receive information and forms to join our PPO networks, call Provider Relations at 800.434.2638. All general dentists and specialists must be credentialed before being accepted as a participating provider. The credentialing process is based on standards developed by the National Committee for Quality Assurance (NCQA) and our provider network.

Is there a fee to join your PPO networks?

There is no fee to join our PPO networks.

How is the quality of the network assured?

We adhere to quality standards encompassing a broad range of care and service issues that are the cornerstone of our Quality Assurance Program (QAP). The program addresses areas of credentialing, utilization reviews, professional standards, the monitoring and resolution of member complaints and appeals, and the assessment of the satisfaction of our providers and eligible members through surveys and evaluations.

How do patients find out that I am a participating dentist?

Your practice information is included in our directory of participating providers and on our website. We also direct patients to participating providers via telephone referrals through our Customer Relations lines.

May I discontinue referrals?

Submit a written request to discontinue new patient referrals. We will process your request as soon as administratively possible. You may reactivate referrals whenever you wish.

Who do I call with questions about my network participation?

You can call Provider Relations at 800.434.2638 from 7:00 a.m. to 4:30 p.m. CT , Monday through Friday.

Who do I call if I have questions regarding my Personal Fee Profile?

You can call Provider Relations at 800.434.2638 with questions, or to obtain your network fee for any procedure not listed in your Personal Fee Profile.

Who do I contact if I have questions regarding my responsibilities with your PPO Networks?

As part of your welcome notification, you were provided a copy of your Participating Dentist Agreement and your Personal Fee Profile. Visit www.dha.com to review The Dentist Guide for guidelines around handling our patients seen in your practice and their claims. We encourage you to refer to this information for any questions you may have. If you have any comments or problems, please call Provider Relations at 800.434.2638.