Provider Resources

For markets that offer members out-of-network dental benefits, providers rendering services must comply with all state and federal law licensing requirements:

Ambetter Health Insurance Marketplace Plans

  • The provider must be licensed for that state

Allwell and Ascension Complete Medicare Advantage Plans

  • The provider must be registered with CMS
  • The provider cannot appear on the Medicare Opt-out or Preclusion list

When submitting claims to Envolve Dental you should include the following information with each claim submitted*:

  • 2012 ADA Claim Form
  • Completed W-9 with payee information
  • Any supporting documentation for the services submitted

NOTE: To avoid claims being rejected, providers must submit paper claims.

*Claims submitted by out-of-network providers in markets where members do not have an out-of-network benefit will be rejected or denied.

Envolve Dental Provider Manuals

Questions? Please call Provider Services at the phone number indicated in the applicable provider manual.

Arkansas, Indiana, Kansas

Antwan Perez-Alvarez 727-437-1723

Michael Williams 727-437-1832

Florida, Georgia, Ohio, South Carolina

Cherie McCarter 727-437-1833

Tyneshia James 727-437-1755

Louisiana, Mississippi, Pennsylvania, Texas

Melinda Clesca 727-437-1814

Zariana Ortiz 727-437-1808


Enrique Echave 727-437-1742

Alegna Ventura 252-544-9299

Arizona, New Mexico

Alegna Ventura 252-544-9299

Enrique Echave 727-437-1742

Illinois, Michigan, Missouri, Wisconsin

Tony Smith 727-437-1781