Members

How Altus Dental Works

Receiving care from a participating network dentist will save you money. To make sure you get the maximum out of your dental plan, it's important to know how your plan works.

Maximize your coverage with participating dentists

Choose from an extensive network of dentists. With a continually expanding list of participating dentists, you're sure to find one that's right for you.

And by choosing a participating dentist from the network, you get the best value from your dental plan. That's because participating dentists agree to accept the allowance as full payment. That means that they will not bill you for any difference between the amount we allow and their actual charge.

Finding a participating dentist is easy - just click here to begin your search. If your dentist does not participate with Altus Dental, click here to send us his or her name and address, and we'll contact the office directly.

Learn more about how your plan works:

Use a participating dentist
What happens if you use non-participating dentists?
What to do in an emergency

Use a participating dentist

When you receive care from a participating dentist, there’s no balance billing. Participating dentists handle all the claims, paperwork and inquiries directly with us. At non-participating dentists, you may be asked to pay first, then submit a claim, and you’ll be reimbursed up to the allowance.

  • At the participating dentist's office, show your identification card and discuss your treatment. After your visit, the dentist's office will file the claim and we will pay the dentist for covered services.
  • If your dentist relocates or no longer participates with Altus Dental, you can choose a new participating provider from our network without any disruption in your coverage or benefits.
  • If your dentist does not participate with Altus Dental, click here to send us his or her name and address, and we'll contact the office directly.

What happens if you use non-participating dentists?

You have the option of going to a non-participating dentist. However, when you go to a non-participating dentist, it may cost you more money. That’s because non-participating dentists expect you to pay for any difference between the amount Altus Dental allows and the amount the dentist charges.

You may also have to file the claim and be reimbursed directly. In that situation, you should pay the dentist’s charges and mail a claim form to:

Altus Dental Insurance Co., Inc.
PO Box 1557
Providence, RI 02901-1557

What to do in an emergency

  • You are covered for procedures rendered in a dental office by a licensed dentist, provided they are covered benefits under your plan. Altus Dental only covers services received in a dental office; we do not cover services rendered in a hospital, surgi-center or urgent care facility.
  • In the event of a life-threatening emergency, you should go to the nearest hospital for treatment and submit any claims to your medical insurance plan. Similarly, if you have an urgent dental condition, you should seek treatment at the nearest dentist's office, regardless of whether the dentist participates with Altus Dental. You do not need prior approval before seeking treatment, however, your dental plan will only pay for covered benefits.
  • Most dental offices treat patients within 24 hours for an urgent appointment. If you need help selecting a participating dentist, call customer service for a list of dentists in your area or search online.