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Provider Area

You asked, we delivered. Your online dental claims, eligibility and benefits website has changed!

Based on your input, we launched a brand new dental provider website. All the functions from our previous sites are now consolidated into a new dental web portal powered by Availity including enhancements and upgrades, making it easier to do business with us.

The new and improved website is available NOW. Visit www.availity.com/dentalproviders.

What you need to know

  • You get one easy website for claims and attachments.
  • Check eligibility and benefits, manage claims, view remittances, and complete secured administrative tasks online.
  • If you currently do not have an account set up with Availity, you can easily create one. Once you are set up, remember to bookmark the new site for quick access every time.
  • Training is free online and available at your convenience no need to schedule.
  • More detailed information about the new web portal is available in the FAQs.

To register for the new portal, visit www.availity.com/dentalproviders and select Register in the upper right corner. Already registered? If so, now is the time to make sure your tax IDs and other important information are registered on the new web portal.

How To Become A Provider

For over 30 years dental and vision providers have looked to Golden West to complement their private practices. Through our partnership with these doctors we have incorporated their feedback into our programs. Little wonder then that we are considered the "Doctor Friendly Plan."To find out why, just give us a call at 1-866-947-9398 or email our Network development department.  Our dedicated and experienced staff will answer all of your questions and provide you with everything you need to join Golden West Dental & Vision.

Provider Maintenance Form

Click here to complete the Online Provider Maintenance Form

Click here to view Online Provider Maintenance Form Updates

Click here to view the Provider Maintenance Form Instructions

National Provider Identifier (NPI)

Click here for instructions and application for a National Provider Identifier (NPI) with National Plan and Provider Enumeration System NPPES) - National Provider Identifier (NPI) Application

Click here to submit or update your NPI to Golden West: National Provider Identifier (NPI) Online Submission Form.

If you have received your NPI, please select the link above to complete our online submission form to register your NPI with us.  This form helps to guarantee that our internal systems accurately reflect your NPI and demographical information.  By registering your NPI with us, you can help secure a seamless conversion to NPI, minimizing any potential payment disruptions in your operations with us.

Communication/Notifications

Language Assistance Program for your Office

Clinical Guidelines

01-101 Dental Prophylaxis

01-102 Interim Caries Arresting Medicament Application

02-701 Crowns Inlays and Onlays

02-901 Core Buildup includes post and core procedures

02-902 Veneers

03-001 Endodontic Therapy

03-401 Biological Materials to Aid in Soft Tissue and Osseous Tissue Regeneration (Endodontic)

04-201 Bone Grafts for Surgical Services (Periodontal)

04-202 Gingivectomy or Gingivoplasty

04-203 Biological Materials to Aid Soft and Osseous Tissue Regeneration

04-204 Mucogingival Surgery and Soft Tissue Grafting

04-205 Osseous Surgery (Periodontal)

04-206 Clinical Crown Lengthening

04-207 Gingival Flap Procedure and Apically Positioned Flap

04-208 Periodontic Surgical Procedures, miscellaneous

04-209 Guided Tissue Regeneration

04-301 Scaling and Root Planing

04-302 Local Delivery of Antimicrobial Agents

04-901 Periodontal Maintenance

06-001 Implant Fixed Prosthetics - Crowns and Fixed Bridges

06-101 Implant Body (Fixture)

06-102 Implant Maintenance Procedures

06-103 Management of Peri-Implant Defects

06-104 Implant Supported Removable Prosthetics

06-701 Abutment Crowns and Fixed Partial Dentures

07-101 Removal of Teeth

07-201 Removal of Third Molar Teeth

07-800 Occlusal Orthotic Device

07-901 Bone Grafts for Dental and Oral Surgical Services

08-001 Orthodontia - Medically Necessary Orthodontia Care

08-002 Orthodontia - Non-Medically Necessary Orthodontia Care

09-201 Anesthesia

09-400 Occlusal Guard

09-600 Therapeutic Parenteral Drug Administration

09-900 Teledentistry

Admin-02 Claims and Pre-determination Submission Requirements

Clinical Policy-01 Generally Accepted Standard of Dental Care

Clinical Policy-02 Accidental Dental Injury