Frequently Asked Questions...
  1. How can I find a dentist?
    Please use our Find a Dentist online search function or click on the “Member Hotlines” tab above for a complete listing of our Member Hotlines that you can call for assistance.
  2. What are the Member Hotline office hours?
    Our office hours are 7am-7pm Central Time Monday through Friday, excluding national holidays.
  3. Is there a separate telephone line for hearing and speech impaired members?
    Yes. Hearing and speech impaired members can call 1-800-508-6975 or 1-262-834-3929.
  4. Can I go to an Out of Network Provider?
    Scion Dental strives to build adequate provider networks void of service holes. In rare circumstances where you cannot locate a participating provider within a reasonable mile radius near your area, please click on the “Member Hotlines” tab above for a complete listing of our Member Hotlines that you can call for assistance.
  5. Can I refer a dentist who is not in your network?
    Yes. You can refer a Dentist by completing a brief form at Refer a Dentist.
  6. What is covered under my plan and what are the frequency limitations?
    The details of what dental services your plan covers annually are determined by your insurance provider. Please refer to your Member Handbook for benefit level details, or click on the “Member Hotlines” tab above for a complete listing of our Member Hotlines that you can call for assistance.
  7. Do I have out-of-pocket expenses?
    You are responsible to pay for all non-covered, non-emergency dental services and for any service that exceeds your benefit limit. Payment for out-of-pocket expenses will be due to your dental service provider per their payment arrangements.
  8. Who can I talk to about my dental benefits?
    Please refer to your Member Handbook for contact numbers or click on the “Member Hotlines” tab above for a complete listing of our Member Hotlines that you can call for assistance.
  9. How do I update my address?
    To update your address information, please click on the “Member Hotlines” tab above for a complete listing of our Member Hotlines that you can call for assistance.
  10. What is the relationship between Scion Dental and my insurance provider?
    Scion Dental has contracted with your insurance provider to provide dental services. Scion Dental performs any administrative tasks delegated to us by your insurance provider.
  1. How does Scion Dental reimburse providers?
    Scion Dental has the ability to reimburse according to several different strategies. Your reimbursement method will be determined by the contracted MCO or HMO, and will be reviewed with you during contracting. Scion Dental has adopted these reimbursement strategies:
    • Fee-for-service
    • Capitation
    • Per encounter
    • Per visit
    • Case fees
    • Global budgeting
    • Salary
    • Any combination based upon code groups or location
  2. Where can I find my fee schedule?
    You will receive a copy of your fee schedule upon contract. Your fee schedule can also be accessed anytime via:
  3. How often are claims paid?
    Scion Dental will process and pay claims according to applicable client and state prompt pay guidelines. For more information please contact our Provider Hotline at 1-877-724-6602.
  4. How can I verify member eligibility and service history information?
    Your office can:
    • Log on to the Provider Web Portal
    • Call Scion Dental Provider Hotline at: 1-877-724-6602.
    • Scion Dental’s Provider Hotline is managed by an IVR which allows you to look up eligibility automatically. The IVR is available 24/7 for your convenience, with an option to speak to a customer service representative.
  5. What CDT codes require a prior authorization and what documents do I need to submit?
    Information on CDT codes that require a prior authorization and the needed documentation can be obtained by:
    • Logging onto the Provider Web Portal
    • Referring to your Provider Manual
    • Contacting our Provider Hotline at 1-877-724-6602.
  6. How do I enroll to receive EFT (electronic funds transfer) payments?
    The EFT form is located in your Provider Manual and on our Provider Web Portal. Once completed, the form can be mailed, faxed, or emailed to the Provider Services Department. Scion Dental does not require a voided check as part of the EFT application. However, the form does require you to document your account and routing number taken from a blank check. Note: These numbers must be supplied from a check and not a deposit slip to ensure the EFT will process correctly.
  7. How do I submit an authorization or a claim?
    Claims and authorizations can be submitted via:
  8. What clearing houses can I use to submit claims and authorizations electronically? What Payer ID# should I use?
    Scion Dental is currently contracted with DentalXchange and Emdeon clearing houses. Our Payer ID is “SCION”.
  9. What happens when you have to refer out-of-network for a specialist?
    Scion Dental strives to build adequate provider networks void of service holes. In rare circumstances where you cannot locate a participating provider, please contact Provider Hotline at 1-877-724-6602 for assistance.
  10. Will Scion Dental accept HIPAA compliant electronic claims (837) and provide electronic remittance (835)?
    Yes, Scion Dental will accept HIPAA compliant 837 claims, and will return HIPAA compliant 835 remittance advice for those claims.

Our Member Hotlines are available during office hours 7am-7pm Central Time Monday through Friday excluding national holidays.

State-PlanNumber
Hearing/Speech Impaired800-508-6975 / 262-834-3929
Florida- AGP877-408-0885
Georgia – AGP800-608-9563
Mississippi –UHC800-992-9940
Nevada – AGP877-378-5302
New Jersey – UHC800-941-4647
New York - Access Med877-408-0170
New York – UHC800-493-4647
New Mexico – UHC877-408-0160
Ohio – AGP877-408-0884
Pennsylvania – UHC800-414-9025
Rhode Island –UHC866-375-3257
Tennessee – UHC800-690-1606
Texas - UHC877-378-5294
West Virginia – Unicare877-408-0917