Providers

FOR HIPAA COMPLIANT EDI ELECTRONIC CLAIM PAYMENT SUBMISSION:

Sele-Dent guarantees to fully comply with the eight HIPAA mandated “EDI” Electronic Data Interchange requirements effective October 2003.

Sele-Dent utilizes EMDEON E-SERVICES for electronic claim submission The PAYOR ID NUMBER is: CX109.

Real-Time transactions through the E-SERVICES shall be available seven (7) days a week, twenty-four (24) hours a day, except during downtime or as may otherwise be set forth in the EDI Specifications for such transactions.

Sele-Dent agrees to make any amendment(s) to Protected Health Information in a Designated Record Set that the Fund directs or agrees to at the request of the FUND or individual, pursuant to 45 CFR 164.526

Sele-Dent agrees to comply with all HIPAA Compliant Physical and Electronic Safeguards to ensure the protection of Protected Health Information (PHI) and has procedures set forth to advise of a breach of such information.

FOR ELECTRONIC ELIGIBILITY PLEASE CALL THE SELE-DENT OFFICE FOR FURTHER INSTRUCTIONS.

To begin receiving the benefits of participation with Sele-Dent, please fill out the contact information below or contact our provider relations department at 1-800-520-DENT (3368) or email providerrelations@sele-dent.com.

Sele-Dent accepts new participating providers on a continual basis. Click here to download both a Provider Application and Agreement.