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.

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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 the nation's largest dental insurer of state-sponsored Medicaid and CHIP programs.

A National Leader in Dental Insurance

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MCNA Dental is the largest dental insurer 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. Over 3.5 million members across 7 states 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.

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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.

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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.

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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.

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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. 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 ProView
Preferred 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 and one New Location Form for each physical location that would render services.

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.

  • Texas Medicaid and CHIP Provider Manual

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.

Upcoming Training Webinars

Posted: May 1, 2024

MCNA is hosting the following online webinar training sessions:

May 28, 2024

  • 11:00am or 1:30pm: Corrected Claims Process

June 25, 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.

View News Article

Dental Details Newsletter: Spring 2024

Posted: April 5, 2024

The next issue of MCNA’s provider newsletter, Dental Details, is now available! Check your email or download the latest issue.

In this issue:

  • Recent Changes to MCNA's Provider Portal

  • 2024 CDT Code Changes

  • Recognizing Dentists and Dental Hygienists

  • New Clinical Practice Guidelines

  • Question of the Quarter

If you are not subscribed to receive the newsletter each quarter, you can easily sign up by clicking “Manage Your Mailing List” in your Provider Portal account. We also recommend that you check your Mailing List periodically to ensure the email addresses for your office are up-to-date.

Important Notice for Your Office

Posted: March 20, 2024

Claims clearinghouse Change Healthcare recently experienced a cyber security issue that may have affected your practice's ability to submit patient claims and prior authorizations. Claims received through alternative methods will result in timely processing and payment. Please read our provider bulletin to learn more.

Happy National Dentist's Day from MCNA!

Posted: March 5, 2024

The spring months are a great time to celebrate dental professionals. March 6th is National Dentist’s Day, and the second week of April is Dental Hygienists’ Week. On behalf of MCNA, thank you for the great dental care you provide and the positive impact you make on oral health in your community.

Reporting Missed Appointments to MCNA

Posted: February 22, 2024

MCNA is excited to announce an enhancement to our system that allows providers to report when a member has missed a dental appointment. With this enhancement, MCNA continues to support your practice in the reduction of missed appointments. Read our provider bulletin to find out how.

View All News

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!

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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, CDT, 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 Email

Send 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

Stay connected with our latest news and events, oral health tips, videos, and more when you follow our social media profiles.

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