Active Duty Officer Dental Program
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Overview
United Concordia Companies, Inc. (UCCI) is the TRICARE dental contractor for Active Duty Service Members and Active Duty Family Members:
- UCCI will process all PHS dental claims
- UCCI will be responsible for all pretreatment determinations (e.g. authorization for complex procedures such as periodontal surgery and multiple crowns)
- The appeals process for denied claims will be initiated by you or your authorized party to UCCI
- UCCI will provide an Explanation of Benefits (EOB) to officers and their dental provider for each episode of care
Reimbursement
UCCI dental providers will be reimbursed at 100 percent oer (i.e. per instance) UCCI's network maximum allowable fee schedule and will submit claims to UCCI on your behalf.
Non-network providers may request that you pay the entire fee at the time of service. In this case, it is the officer's responsibility to submit the claim to UCCI for reimbursement.
Coverage
Your PHS dental entitlements include coverage for
- Diagnostic and preventive services (exams, cleaning and x-rays)
- Restorative services (silver and tooth colored fillings)
- Endodontics (root canals)
- Prosthodontics (crowns)
- Periodontics (gum surgery)
- Oral Surgery (extractions)
(Orthodontics and cosmetic dental services are not covered.)
Diagnostic and Preventative Services
Diagnostic and preventative services include exams, cleanings, and x-rays.
Exams: Three routine oral evaluations are eligible during a twelve (12) consecutive month period. However, only two oral evaluations may be performed by the same office in the 12-month period.
Cleanings: Two routine cleanings are eligible in a twelve consecutive month period. Two topical applications of fluoride are eligible in a twelve consecutive month period.
X-rays: One full mouth radiograph series or panoramic radiograph is eligible in any 36-month period. One occurrence of bitewing radiographs, consisting of up to four bitewing radiographs per occurrence, are eligible during a 12 consecutive month period. An occurrence is a number of bitewings (2, 3 or 4) taken on the same date of service.
Register and View Your Benefits
For detailed information regarding the PHS Dental Program, please register for My Dental Benefits through UCCI's PHS website. My Dental Benefits allows you to view benefits and eligibility information, check on the status of a claim, view past treatment information, request a new ID card, and find a provider in your network at any time of day.
To register for My Dental Benefits:
Select Client's Corner (bottom left corner)
Under the letter P select Public Health Service
Under Online Service select My Dental Benefits
Select Register (gray box)
Click OK
Follow the instructions for completing the Membership Registration Form.
Questions or Concerns
Please utilize the following contact information for any questions/concerns regarding your dental entitlements:
United Concordia Contact Information
Claims/Predeterminations and Written Inquiries:
United Concordia
PHS Customer Service
P.O. Box 69425
Harrisburg, PA 17106-9425
Telephone Inquiries:
1-877-261-2379 (toll free)
1-717-260-6866 (toll)
Monday - Friday, 8 AM - 8 PM EST
E-mail Inquiries: phs@ucci.com