Payers: national carrier
Automated insurance verification for Anthem dental plans
Anthem is one of the 71 payers Ardent runs a playbook for. For each scheduled patient on a Anthem dental plan, Ardent works the payer’s own channels in order: Availity first, then a requested benefits fax or a clearinghouse 270/271 where that is how the payer answers, then a recorded phone call to the provider line for anything still open. It fills the breakdown sheet your office already uses and files it in the patient’s chart before the visit.
- A Anthem playbook: Availity first, with your practice’s credentials.
- Every value keeps its source: the portal record and screenshot, the fax lines, or the rep’s recorded words.
- A recorded phone call only for required blanks still open, up to two calls, every answer quote-backed.
- Your own sheet, in your notation, as a PDF in the patient’s chart before the visit.
How it works
How does Ardent verify Anthem dental benefits?
Anthem directs dental offices to its web portal powered by Availity to check eligibility and benefits (Anthem). Where it has the answer, Ardent signs in with your practice’s credentials, reads the benefit grid field by field and keeps the record and screenshots as the source. Values are typed into your blanks in the shorthand your team already reads, and a blank no one stated stays blank.
- Sign in. To Availity, with your practice’s own credentials, used only for the call that needs them and never sent to a model or a log.
- Benefit grid. Maximum and remaining, deductible, coverage by category, frequency and age limits, waiting periods, missing tooth and downgrade clauses, and history where the payer shows it.
- The rest, if any. A required blank still open goes to a requested benefits fax where the payer offers one, then to a recorded call inside the payer’s business hours.
- Filed. The finished sheet as a PDF in the patient’s chart documents, with notes in the PMS fields your team uses.
Know the payer
What to know about verifying Anthem dental
Not always. In some states Anthem’s Medicaid dental benefits are run by a separate dental company: in Ohio, Anthem’s Medicaid dental is through LIBERTY Dental (Anthem Ohio Medicaid). The member’s ID card and the plan on file decide whose channel answers, and a plan Ardent cannot check yet is named in the 7:00 AM email.
Anthem’s dental plans include commercial and individual dental, among them Dental Prime and Dental Complete (Anthem), a DHMO in California, Dental Net 3000 (Anthem), and Medicaid and Medicare Advantage plans that include dental. Anthem is the Blue Cross Blue Shield licensee in states including Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin, and Anthem Blue Cross in California (Anthem).
Anthem lists Dental Provider Services at 1-866-947-9398, weekdays 7 a.m. to 5 p.m. Central (Anthem).
The exceptions
What happens when a Anthem plan can’t be verified?
Nothing is guessed. When the payer cannot match the patient to the insurance on file, the plan has ended, or a required blank stays open after the call, the appointment is set to "Needs info" or "Someone has to call", the reason goes to your front desk in the 7:00 AM email in plain words, and, where your practice management system allows a note, one line goes on the appointment. When a portal is temporarily unavailable the check is retried, and failures that will clear on their own retry after 6 and 48 hours.
Answers
Anthem insurance verification FAQ
Yes. Anthem is one of the 71 payers Ardent runs a playbook for. Ardent works the payer’s own channels in order, Availity first, fills your breakdown sheet and files it in the patient’s chart before the visit.
Anthem directs dental offices to its web portal powered by Availity to check eligibility and benefits (Anthem). Ardent signs in with your practice’s own credentials.
Not always. In some states Anthem’s Medicaid dental benefits are run by a separate dental company: in Ohio, Anthem’s Medicaid dental is through LIBERTY Dental (Anthem Ohio Medicaid). The member’s ID card and the plan on file decide whose channel answers, and a plan Ardent cannot check yet is named in the 7:00 AM email.
Yes, for portal automation. Credentials live only for the duration of the call that needs them and never enter a model, a log line or a response; every portal request is limited to the payer’s domain; emailed one-time codes are read from a mailbox you designate; Ardent never solves CAPTCHAs.
Only if a required blank is still open after the portal or the fax. When a call runs, the agent dials the provider line inside the payer’s business hours, works the menu through to a rep, asks only the open questions, and writes an answer only with a quote from the rep behind it. Up to two calls per run.