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Forms FAQs

Choose your state to find the correct forms

Here are a few answers to the most common questions

  • When necessary, where should claims be sent?

    Claims Adminstration
    PO Box 851917
    Richardson, TX 75085

  • How do I submit an address change?

    Address or other contact information changes may be submitted in writing directly to our Corporate Office via fax, mail or email. Please locate the contact information below.

  • How do I request a plan to be closed to new patients?

    You may elect to close a plan or plans at any time to new patients. All requests must be submitted in writing on your company letterhead and are effective immediately upon receipt of notification. You may fax, mail or email your requests. Please locate the contact information below.

  • How do I terminate network affiliation?

    All requests must be submitted in writing on your company letterhead. There is a 90 day termination period during which time the provider is responsible for contacting all existing patients who may be affected.  Upon receipt of the termination request, the Provider will no longer be listed in the Dental Select Provider Directories for that specific plan or plans. You may fax, mail or email your requests – please locate the contact information below.

  • How do I add a plan to my affiliation?

    You may add a plan by contacting your Professional Relations Specialist or our Corporate Office for an additional plan contract. Contracts may be faxed or mailed. Please locate the contact information below.

  • Dental Select recently added new plans. Why?

    Due to the rising cost of medical insurance premiums, many companies are choosing to shift to voluntary plans paid by the employee or are eliminating dental coverage completely. These new plans offer additional dental plan choices without reducing your total reimbursement, allowing patients more options and access to dental health benefits.

  • Do I have a representative that can assist me with issues?

    All Dental Select Preferred Providers have a personal Professional Relations Specialist assigned to assist with any questions or issues that may arise. Please call a customer care representative for your area’s specialist at 800-999-9789.

  • How do I obtain an Adminitrative Guide?

    You may download one from our website in the Forms section above. You may also request one from our Corporate Office by calling 800-999-9789.

  • How do the fee schedules work?

    The Total Fee columns on your Fee Schedules designate the Total Contracted Fee for any plan on that Fee Schedule. This column is used to calculate benefit percentages for the co-insurance plans. Additional information on the fee schedules can be found on the Plans Overview document or in your Administrative Guide.

  • How will I know what plan my patient is on?

    Your patient’s ID card will specify the Fee Schedule (Network), plan type, and other plan specific information, such as options and deductibles.

Dental Select Offers Provider EFT & EDI

Simplify your office. By submitting electronic files, claims turnaround time, postage and labor costs will be considerably reduced. Find out today how Electronic Data Interchange can benefit your practice.

Call a Dental Select Customer Care Representative toll free at
1-800-999-9789 for personalized assistance.

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