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WHAT WE OFFER

MEDICAID/CHIP DENTAL BENEFITS SOLUTIONS

As the largest government dental benefits administrator in the U.S., 30% of all Medicaid/CHIP enrollees are covered by DentaQuest. Our Medicaid/CHIP dental benefits solutions effectively control program costs while increasing member access to care.

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Dental Done Better: The DentaQuest Difference

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Dental as a differentiator

We’ve invested millions of dollars and our best resources to build the infrastructure, systems and processes needed to master dental benefits management. Take a look under the hood of Windward, our proprietary claims adjudication system, to see how we keep your programs humming.

Explore Windward
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Flexible and Scalable Plan Design

Not every state’s Medicaid program looks the same. We support all types of state-sponsored programs, including full risk, risk-share models and carve outs.

  • Optimize plan performance and prevent fraud, waste & abuse with utilization analysis and management supported by highly effective and customizable control measures
  • Turn data into actionable insights on program performance, cost drivers, utilization trends and other key program KPIs with, monthly, quarterly and ad-hoc reports
  • Access data anytime through secure, HIPAA-compliant web portals for members, providers and clients

Best-in-Class Member Experience

We’ve tested, refined and proven our processes to make the most of every client’s program. Trust us to help you increase HEDIS scores and member satisfaction.

  • Omnichannel member engagement - Meet all members where they are with printed welcome kits, teledentistry, mobile apps, SMS, contact centers with a 24-hour integrated voice response system and more
  • Case management - Care coordination connects high-risk members with the resources they need to achieve optimal oral health.
  • Medical-Dental Integration - Integrated care plans decrease the number of emergency department visits and overall healthcare expenses.

Value-Based Care Improves Outcomes and Reduces Costs

When you empower providers to improve patient experiences and better manage costs, the result is increased satisfaction and a network eager to treat more of your members.

  • Align incentive payments with desired care and outcomes to increase the overall health of a target population
  • Providers are reimbursed for reporting data, improving risk stratification, greater medical-dental integration, increasing prevention opportunities and decreasing oral disease
  • Lower overall cost of treatment and care balances the increase in member utilization of prevention-focused services

Dental Homes Increase Access to Quality Care

Dental Homes foster consistent, quality care and oral health connections in the local community that many members lack, setting them up for a lifetime of improved dental and overall health.

  • Ensemble framework identifies and rewards higher-performing providers
  • Care and support from higher-performing providers creates positive experiences for members 
  • Digital Provider Performance Reports track results and support continuous improvement

Reliable Member Access to Quality Dental Care

Time-tested recruitment strategies and network support from local teams ensures your members have access to the right providers when and where they need care, from routine prevention to restorative treatments.

  • A network of more than 100,000 access points nationwide wrapped with teledentistry services for 24/7 coverage
  • Digital Performance Reports track provider performance according to claim volume, diagnostic codes, and other categories
  • Simple and intuitive onboarding, claims processing and administrative management makes dentists want to treat more of your members

Explore other Dental and Vision Solutions

Oral Health News & Resources

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News Release

DentaQuest, part of Sun Life U.S., donates $100,000 to Healthfirst Foundation to support access to dental care for underserved communities

Sponsorship is funding grants to New York-based dental schools and professional associations

Tony Mollica

News Release

Sun Life U.S. names Tony Mollica as new dental business leader

Former Humana executive to lead all of Sun Life U.S. Dental, focused on growth and promoting improved oral health for all

Dr. Todd Gray

News Release

DentaQuest’s Chief Dental Officer Named to TeamSmile Board of Directors

Dr. Todd Gray’s passion for oral healthcare aligns with Sun Life and TeamSmile missions to provide children in need with life-changing dental care

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PREVENTISTRY PULSE

The newsletter designed for anyone who wants to improve oral health for themselves, their families, customers or communities.