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.

Using Bots Can Lead to Revoked PWP Access

When accessing the Provider Web Portal (PWP), always sign in using your own individual account. Please do not share your login credentials with anyone.

There has been an increase in unauthorized bot accounts created within dental provider offices nationwide. These fake accounts are being used to impersonate legitimate PWP users and access information such as eligibility or claim status. To help prevent this, it’s essential that you keep your password confidential.

The use of bots to access the PWP is strictly prohibited and can lead to system disruptions. If it is determined that bots are being used under your account, your access to the PWP may be permanently revoked.

Beware of Fraudulent Payment Requests

There have been fraudulent communications sent via email to providers appearing to be from Centene Dental requesting payment. Please review the sender’s email address carefully before responding. All emails from Centene Dental will come from a @centene.com or @envolvehealth.com email address.

If you receive a communication that you are unsure about, please contact the Customer Service number listed in your Plan Specific to confirm whether any action is needed.

Local Market Reminders

Below are important reminders for Ohio:

• New HLD Form – Effective Jan. 1, 2026, Centene Dental Services clinical policy CP.DP.5.OH has been created to reflect changes made to the Orthodontic Treatment Form 03630 by the Ohio Department of Medicaid (ODM). The revised form replaces all previous versions and associated criteria. The form is posted on the Centene Dental Provider Web Portal and our website.
• Submit Claims to ODM Fiscal Intermediary – For OH MyCare claims submitted through clearinghouses, please submit directly to the ODM FI using Centene Dental’s Payor ID #D004202. EDI claims submitted directly to Centene Dental after March 15, 2026, will be rejected regardless of the date of service.

Supporting Health Equity Through CLAS

Centene Dental has adopted the Culturally and Linguistically Appropriate Services (CLAS) Standards, as developed by the U.S. Department of Health and Human Services, Office of Minority Health. These standards serve as a key resource in supporting the delivery of culturally sensitive, high-quality care to diverse populations. To support providers in applying these principles in practice, we encourage participation in the "Culturally Appropriate Care and Health Equity" course offered by the Centene Institute for Advanced Health Education. This course explores how culturally appropriate care can improve patient outcomes, safety, and experiences in healthcare.

How to Create an Account and Register

If you have not set up a profile with the Centene Institute, click “Register” and select “Create New Account.” Complete all required fields and submit your information. Once logged in, return to the course page, select “Register,” and then click “Take Course” to begin.

Your Go‑To Resource for Dental Benefit Answers

Use the CDT Dental Code Search Tool along with the Plan Specific to understand the full range of dental benefits. The tool lets you:

• Search benefits by product.
• Look up a specific benefit or procedure.
• Confirm whether a benefit is covered.
• Check if prior authorization is required.

To access the tool, please visit centenedental.com/cdt.

Optimizing Fluoride Care in Pediatrics

Protecting children’s teeth is increasingly important, especially as fewer communities in the United States have access to fluoridated tap water. When caring for pediatric patients, providers should review the fluoride treatment options that are appropriate for each child.

Parents can help safeguard their children’s oral health by ensuring they schedule dental cleanings every six months that include a topical fluoride varnish. They can also be shown the correct amount of fluoridated toothpaste to use based on the child’s age. In addition, a fluoride rinse may be recommended for children over the age of six.

Source: Tufts University: How to Protect Your Child’s Teeth if Your Water Lacks Fluoride

NEW! Digital Provider Update Form

Our provider update form is now fully digital — making it easier than ever to update your information. If your office has experienced any recent changes, please use the new form to notify us. Keeping your information current is essential for members making decisions when choosing care.

Not sure if an update is needed? Use the Find a Provider tool at centenedental.com/fap to search for your profile. What you see is exactly what members see.

Professional Interpreters Support Better Member Care

It is essential to use trained medical interpreters when communicating with members who are non-native speakers. Relying on family members or office staff is not recommended, as it may lead to incomplete, incorrect, or misunderstood information. Using qualified interpreters helps ensure accurate communication and supports the highest quality of care for members.

Translation services are available to members at no cost to them or to you. When scheduling appointments, please make sure all of the member's needs are identified so they can be accommodated. If TTY services are required, call the Customer Service phone number listed in your Plan Specific. Thank you for your dedication to meeting our members’ needs.

Source: Interpreter services and effect on healthcare - a systematic review of the impact of different types of interpreters on patient outcome

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 an integral 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 one to four 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 six-month appointment while patient is on site and make reminder calls to reduce no-show rates

Clinical Policies Posted Online

Centene Dental takes individual circumstances and the local delivery system into account when determining medical necessity of dental services. As a dental benefits administrator, we founded our objective clinical policy guidelines upon evidence-based dentistry to determine medical necessity when making utilization decisions. Our Utilization Management Committee, which is composed of our dental directors, follows a formal process to develop and evaluate all clinical policy guidelines and procedures for applying criteria. Current policies are available on our public website at centenedental.com/policies.

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.