National appointment and availability standards

Q1 Word of Mouth newsletter 2023

Dental Benefit Providers, Inc., a UnitedHealthcare company, is committed to ensuring our members have access to dental professionals participating in our commercial networks. Our standards apply nationally regarding:

  • Standards for emergency coverage
  • Standards for practice capacity and appointment scheduling
  • Standards for walk-in appointments
  • Standards for missed appointments

Emergency coverage

All network dental professionals must be available to members during normal business hours. Members must have access to emergency care 24/7 either through your practice or other resources, such as another practice or a local emergency care facility.

You’re required to have an answering machine, answering service or cell available at all times with after-hours emergency contact information or instructions. The after-hours message must instruct callers on how to obtain services after business hours and on weekends, particularly in the event of a dental emergency.

Practice capacity and appointment scheduling

As a dental professional in our network, you must be accessible and available to our members for the full range of services specified in the UnitedHealthcare Provider Agreement and manual. You’re also required to comply with state-mandated appointment scheduling specifications for elective and routine care appointments and emergency care. Some states set access and availability standards that participating dental professionals must follow.

To help ensure continuity of care for our members and help you to meet our standards and the capacity and appointment requirements set by various states, we’ll verify your availability through member feedback and surveys. We may reach out to your office to review appointment books and visit your waiting rooms. If members express concern or are dissatisfied with office accessibility, we’ll work with you on a corrective action plan.

Walk-in appointments

If your dental office provides care on a “walk-in” or “first-come, first-served” basis, please ensure members don’t experience excessive wait times.

Missed appointments

Informing your patients of office policies relating to missed appointments and fees they could incur can help reduce the number of occurrences.

  • Appointment scheduling guidelines may vary by state. Please confirm if the state(s) where you’re providing services has specific mandates.
  • You’re required to provide access to emergency care if a member has excessive bleeding, pain or trauma
  • We encourage you to schedule appointments to avoid wait times longer than 30 minutes. If you anticipate long wait times, we recommend you notify the members and give them the option to reschedule their appointment.