Centene Dental Services is a leader in exceptional, tailored dental benefits and services for Medicaid, Medicare, and Marketplace member products. Each quarter we give you key information you can use to best serve your patients.

A BRIGHTER, HEALTHIER FUTURE. ONE SMILE AT A TIME.

Beware: Using Bots Can Lead to Revoked PWP Access 

When logging into the Provider Web Portal (PWP), make sure you use your own account. Do not share your information with anyone else. There has been an uptick in unauthorized bot accounts from dental provider offices across the country. These illegitimate accounts are being used to impersonate PWP users and claim status information. To prevent this from happening, please do not share your password with anyone. The use of bots to access the PWP is not permitted. If you are found using bots to access the PWP, you can lose access permanently.  

Local Market Reminders

Below are important upcoming changes:

• Mississippi Medicaid: As of July 1, 2025, Centene Dental now administer dental benefits for Magnolia Health members enrolled in the Children s Health Insurance Program (CHIP).
• Ohio: Ohio dental providers are reminded of the External Medical Review (EMR) process, available when disputing a Buckeye Health Plan decision to deny, limit, or terminate services due to lack of medical necessity. Providers can request an EMR through Permedion within 30 days of a final determination. The process is free, does not interfere with peer-to-peer reviews, and is exclusive to Medicaid managed care and OhioRISE members. For full details, including the necessary forms and instructions, visit the External Medical Review (EMR) page located on the Buckeye Health Plan website.

Your Voice Matters: Tell Us How We Are Doing

Centene Dental sends a Provider Satisfaction Survey annually to receive feedback on how we are doing and how we can better serve you. Providers are encouraged to give feedback regarding credentialing, customer service, utilization management, claims, coordination and quality of care, and general experience.

Surveys were sent to providers in June via the email we have on file for the offices. Please check your spam/junk folders as the email will be sent from an external source (Qualtrics). We look forward to hearing from you!

Have You Completed the HHS Cultural Competency Training?

Centene Dental is committed to providing culturally and linguistically appropriate dental care services in a manner which affirms, values, and respects the worth of the individual member. These services are to be provided to people of all ages, sex, race, color, religion, sexual orientation, and/or national origin, disability, mental or physical disability, or limited English proficiency.

We promote superior quality dental services with culturally competent staff, providers, and contractors. We support the development of healthy provider/member relationships to foster equitable treatment of all members and enhance cultural awareness. We have adopted the Culturally and Linguistically Appropriate Services Standards, as developed by the Department of Health and Human Services, Office of Minority Health, that serves as a key resource in providing culturally sensitive services.

We encourage participating providers to complete the U.S. Department of Health and Human Services Physician Practical Guide to Culturally Competent Care, which equips healthcare professionals with the skills necessary to better treat the diverse populations that they serve.

Protect Your Practice: FWA Reminders

Centene Dental Services conducts regular audits and uses systems to analyze claims to identify possible Fraud, Waste and Abuse (FWA). If any FWA is detected, the Centene Dental Special Investigation Unit will conduct a review that may result in actions against those who are found to have committed FWA. Actions may include:

• Provider education
• More rigorous Utilization Review requirements
• Recovery of monies previously paid
• Extrapolated overpayment calculation
• Reporting to appropriate payor and/or regulatory agencies (OIG)
• Termination from the Centene Dental Network

The most common submissions of FWA:

• Unbundling of codes
• Upcoding
• Misrepresentation of services
• Claims for services not rendered

If you suspect another provider is inappropriately billing Centene Dental Services or if a member is receiving unnecessary services, please contact Centene Dental Services Fraud, Waste and Abuse hotline as indicated. We take all reports of potential FWA seriously and investigate all reported issues.

Improve Scores and Smiles Through HEDIS Measures

Centene Dental Services is committed to improving the health of our community by helping members live healthier lives. Oral health is a vital part of a child's tooth and gum development and overall well-being. 

Because of your vital role in our members' health, we ask for your help to ensure our pediatric and adolescent members schedule the following services yearly: 

Oral Evaluation, Dental Services (OED)

• Medicaid members under 21 years of age who received a comprehensive or periodic oral evaluation with a dental provider
• Applicable CDT Codes: D0120, D0145, D0150

 Topical Fluoride for Children (TFC)

• Medicaid members 1-4 years of age who received at least two fluoride varnish applications
• Applicable CDT Code: D1206

In support of our commitment to disease prevention and the oral health of our members, here are a few ways our providers can help:

• Educate parents/caregivers on the importance of routine dental care and regular fluoride treatments for children
• Reach out to patients who have not had an oral evaluation and help schedule an appointment
• Schedule 6-month appointment while patient is on site and make reminder calls to reduce no-show rates

Digital Technologies Are Changing the Dental Landscape

Digital dentistry technologies have made advancements that improve patient care and cost-effectiveness of treatment. The advancements include artificial intelligence (AI) models, 3D printing, and digital radiographic imaging. These new improvements can capture data more accurately.

Digital radiographic imaging can help with treatment planning and get ahead of any complications that may arise during procedures. AI and 3D printing can also expedite turnaround times for restoration development, which can allow for more personalized care and reduced costs for both dentists and patients.

Source: How digital technologies are changing the dental landscape | American Dental Association

No Referrals Needed

When scheduling dental exams for patients, referrals from primary care physicians (PCPs) are not required when seeing a participating dentist. Questions? Please contact Customer Service.

Appointment Wait Times

Dental Care by the Numbers

About Us

Envolve Dental, doing business as Centene Dental Services is a wholly owned Centene Corporation. Our innovative client solutions, education programs, personal attention, and provider support create a comprehensive dental care system that reduces administrative burden for providers and offers quality dental services for our clients  members. Questions? Please contact our Customer Service team.