Wellcare of Georgia-Dental
Effective January 1, 2013, Avesis will be administering routine dental benefits for Wellcare of Georgia Medicare Advantage Members. Avesis will be utilizing your office to provide dental benefits to members residing in the following Georgia counties: Barrow, Bryan, Butts, Chatham, Chattahoochee, Cherokee, Clayton, Cobb, Columbia, De Kalb, Douglas, Fayette, Forsyth, Fulton, Glynn, Gwinnett, Harris, Henry, Liberty, McIntosh, Muscogee, Newton, Paulding, Richmond, Rockdale, Spalding, Stewart, Talbot and Walton.
Below you will find a sample image of the ID card that members will present for services. Wellcare of Georgia dental members will be in one of the following plans: WellCare Access (HMO SNP) or WellCare Value (HMO-POS).
Members' benefits vary according to their individual coverage. As a participating provider, it is imperative that you verify eligibility and benefits on all members each time they present in your office. Please remember that only the services covered by the member's benefit plan will be paid by Avesis.
WellCare Value (HMO-POS) (Dental 500 Plus) plan benefits include routine preventive services such as exams, cleanings and x-rays, basic restorative, limited periodontal and limited surgical procedures as well as emergency exams. Services are covered up to a $500 benefit maximum per year. WellCare Access (HMO-SNP) (Dental 1000) plan benefits cover not only the routine preventive and periodontal services; but also restorative, endodontic, prosthodontic services and oral surgery services. Services are covered up to a $1000 benefit maximum per year.
If you are not currently an Avesis contracted provider and are interested in participating in these programs, please complete the Provider Credentialing and Contracting paperwork located on the left hand side of the page. All Participating Providers must have an NPI number. If you do not have an NPI number, please click here to apply. If you have any questions please contact one of our Provider Services Representatives at 1-855-214-6777.
Send Completed Materials by mail to Provider Services:
Mail To:Avesis Third Party Administrators, Inc.
10324 Soulth Dolfield Road
Owings Mills, MD 21117