We warmly welcome you to MCNA Dental's provider network for the State of Texas
A Provider Friendly Program for Texas
MCNA Dental is one of the dental plan organizations for Texas Medicaid and CHIP. We serve children and adults enrolled throughout Texas to provide the full spectrum of covered dental services on a full-risk basis.
As a plan led by licensed dentists, we recognize the dedication that dental providers such as you have to the oral health of the patients you treat. We would like to extend an invitation for you to consider joining our provider network to serve our Texas members.
For more information about Texas Medicaid and CHIP, visit the Texas Health and Human Services Commission website.
Company Information
MCNA Dental is one of the nation's largest dental insurers of state-sponsored Medicaid and CHIP programs.
A National Leader in Dental Insurance
MCNA Dental is one of the largest dental insurers of Medicaid and CHIP programs in the nation via direct contracts with state agencies. We were founded by dentists and have been in business for over 30 years. Millions of children and adults trust their smiles to MCNA!
We are committed to providing high-quality services to state agencies and managed care organizations, with the singular mission of improving the health of our members by ensuring access to quality dental care.
MCNA is an active and effective partner to our network providers in the delivery of oral health care and services, and we maintain national accreditations to underscore our commitment to operational quality. MCNA has earned the distinction of becoming the first dental plan in the country to be awarded full URAC Dental Plan Accreditation, and we have also earned NCQA accreditation for Credentialing and Re-Credentialing.
For more information about MCNA, visit our corporate website.
Discover our Focus on the Provider Experience
We are a provider-focused organization, and our high provider satisfaction rates across the country are a testament to the enhanced provider support and services we offer.
User-Friendly Technology
Take advantage of our free web-based Provider Portal to assist with daily administrative tasks. Easily verify eligibility in real-time, submit your claims and prior authorizations, view patient rosters and patient histories, and much more.
Our in-house team of developers utilizes feedback from our network dentists to continuously update our Provider Portal and add new user-friendly features. We also maintain a collection of online tutorial videos to explain how to get the most out of our Portal's features.
Concierge Provider Support
Our dedicated Provider Relations Team is ready to connect via telephone and in person to streamline your administrative tasks and reduce time spent on processing. We engage directly with you during initial orientation sessions and through one-on-one site visits upon request.
We also actively assist provider offices with missed and broken appointments through targeted outreach completed by our team of Member Advocate Outreach Specialists.
Informed Clinical Decisions
MCNA enhances operational efficiency by providing a utilization management program that is overseen by dentists. We adopt and utilize nationally accepted, evidence-based clinical guidelines, including the American Academy of Pediatric Dentistry guidelines, and all clinical reviews are performed by licensed dentists.
As part of our clinical review process, we also offer you the option to engage in peer-to-peer discussions with our in-house licensed dentists at any time.
Our state-specific Dental Advisory Committees serve as the voice of the dental community, allowing participating dentists like you to help guide program growth and provide valuable feedback for continuous quality improvement.
World-Class Customer Service
Our integrated call centers minimize wait times for our members and providers. Our robust training program emphasizes First Call Resolution and Cultural Competency, and our Provider Hotline is staffed with skilled representatives ready to assist with a wide range of provider inquiries.
The majority of MCNA's Call Center Representatives are multilingual. For those languages not spoken in-house, we offer free translation services for nearly 300 languages. We can also coordinate free in-office interpreter services for our members, including American Sign Language.
Network Enrollment
MCNA is currently accepting dental providers who serve enrollees in Texas.
Initial Enrollment Process
We are building a provider network in Texas to serve enrollees in Texas Medicaid and CHIP. We invite you to consider joining our growing network of general dentists and specialists across the state.
To enroll your dental office in our Texas Medicaid and CHIP network, please follow the steps listed below. If you are an existing MCNA provider and would like to provide services at an office location that is already in the MCNA network, you can submit an Add Existing Provider to an Existing Location Form and do not need to complete the enrollment steps below.
You may call our Provider Hotline at 1-855-776-6262 if you have any questions or would like assistance with the enrollment process. We look forward to working with you to serve the Texas Medicaid and CHIP population. Together we can make a difference, one smile at a time!
Complete Credentialing Materials
You may complete your Credentialing Application via one of the following methods:
Option 1: CAQH ProViewPreferred Method
If you participate with CAQH, please log in to the CAQH ProView® Portal and authorize MCNA Dental to access your application.
Option 2: Texas Universal Credentialing Application
Please download and complete the Texas Universal Credentialing Application.
Complete Contracting Materials
Submit Materials to MCNA
News and Resources
Access provider news, documents, forms, guides, and helpful resources.
Provider Manuals
Your Provider Manual includes detailed information about Texas Medicaid and CHIP, including covered services, submission requirements for claims and prior authorizations, dental guidelines, provider responsibilities, and contact information. You may download your Provider Manual below.
Guides and Tools
The resources below contain educational information, helpful guides, and useful tools for our network providers.
Provider Forms
You may download and complete any of the forms below as needed. Please follow the submission instructions within each form, or contact our Provider Hotline if you need assistance.
State and Federal Resources
The following resources and information are available from state and federal agencies related to the provision of dental services for Texas Medicaid and CHIP.
Additional Resources
Below are additional resources and information for our network providers.
News Feed
Read the latest news and information from MCNA for our Texas Medicaid and CHIP providers.
Provider Nondiscrimination for Vaccine Status
Posted: November 7, 2024
MCNA would like to share some important information with you regarding House Bill 44 and amendments to Texas Government Code regarding provider nondiscrimination for vaccine status. Please read our latest Provider Bulletin to learn more.
Clinical Practice Guidelines Updated October 2024
Posted: October 23, 2024
We have updated our Clinical Practice Guidelines (CPGs). MCNA's approved CPGs can be found under the "Guides and Tools" section of our website and the "Support and Downloads" page in the Provider Portal.
Join MCNA at SmileCon 2024
Posted: October 9, 2024
ADA members, get ready for SmileCon 2024! Come visit the MCNA team on October 18-19 at booth #543 to snap some pictures at our selfie studio and register for our iPad raffle. Looking forward to seeing our Dental Superheroes in New Orleans!
Important Benefit Updates
Posted: October 2, 2024
MCNA would like to share some important information with you regarding changes to the administration of vaccines effective October 1, 2024. Please review our provider bulletin carefully and contact MCNA Provider Relations with any questions you may have.
Upcoming Training Webinars
Posted: October 2, 2024
MCNA is hosting the following online webinar training sessions:
October 29, 2024
11:00am or 1:30pm: Corrected Claims Process
November 26, 2024
11:00am or 1:30pm: CHIP Presentation
December 17, 2024
11:00am or 1:30pm: Credentialing
Please visit our Provider Training Webinars page to RSVP at least 24 hours before the scheduled webinar to ensure that you receive an invite. For questions, please contact the MCNA Provider Hotline at 1-855-776-6262.
Provider Portal
MCNA's free Provider Portal allows you to quickly verify member eligibility, submit claims and prior authorizations, manage your office, edit your fee schedules, and more! We welcome you to create your Provider Portal account today!
Provider Training Webinars
We host online webinars to discuss our program and other important information. Please reserve your seat at one of our upcoming sessions.
Contact MCNA
Our representatives are ready to assist your office with the enrollment process and help you find answers to any questions you may have.
Call our Provider Hotline
If you have any questions, the easiest way to contact MCNA is to call our toll-free Provider Hotline at 1-855-776-6262. You can call Monday through Friday, from 7am through 7pm, CST, excluding national holidays.
If you call after regular business hours, you can leave a message on our secure voice mailbox. We will return your call the next business day.
Email Provider Relations
You may contact our Provider Relations team using our email form or by sending an email directly to TX_PR_Dept@mcna.net.
Send EmailSend Postal Mail
We recommend submitting any materials to MCNA electronically for the fastest service. If you need to send hard copy materials to us, you may use the mailing addresses below.
Paper Claims
Send paper claims via postal mail to MCNA at:
MCNA Dental
P.O. Box 23920
Oakland Park, FL 33307-3920
All Other Mail
Send all other postal mail to MCNA at:
MCNA Dental
P.O. Box 740370
Atlanta, GA 30374-0370
Social Media
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