We warmly welcome you to MCNA Dental's provider network for the State of Florida
A Provider Friendly Program for Florida
MCNA Dental is one of the dental plan organizations for Florida Healthy Kids. We serve children, ages 5-18, enrolled in CHIP throughout Florida to provide the full spectrum of covered dental services on a full-risk basis.
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 Florida members.
For more information about Florida Healthy Kids, visit the Florida Healthy Kids Corporation website.
MCNA Dental is the nation's largest dental insurer of state-sponsored Medicaid and CHIP programs.
A National Leader in Dental Insurance
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 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.
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.
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.
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.
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.
MCNA is currently accepting dental providers who serve enrollees in Florida.
Initial Enrollment Process
We are building a provider network in Florida to serve enrollees in Florida Healthy Kids. We invite you to consider joining our growing network of general dentists and specialists across the state.
To enroll your dental office in our Florida Healthy Kids network, please follow the steps listed below. You may call our Provider Hotline at 1-855-698-6262 if you have any questions or would like assistance with the enrollment process. We look forward to working with you to serve the Florida Healthy Kids 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 ProViewPreferred Method
If you participate with CAQH, please log in to the CAQH ProView® Portal and authorize MCNA Dental to access your application.
Complete Contracting Materials
Submit Materials to MCNA
News and Resources
Access provider news, documents, forms, guides, and helpful resources.
Your Provider Manual includes detailed information about Florida Healthy Kids, including covered services, submission requirements for claims and prior authorizations, dental guidelines, provider responsibilities, and contact information. You may download your Provider Manual below.
Guides and Tools
The resources below contain educational information, helpful guides, and useful tools for our network providers.
You may download and complete any of the forms below as needed. Please follow the submission instructions within each form, or contact our Provider Hotline if you need assistance.
State and Federal Resources
The following resources and information are available from state and federal agencies related to the provision of dental services for Florida Healthy Kids.
Read the latest news and information from MCNA for our Florida Healthy Kids providers.
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.
Updated Provider Manual Available for Review
Posted: February 9, 2024
A preview of our revised Florida Healthy Kids Provider Manual is now available. This revised version will go live in early March 2024 and be effective from February 1, 2024. As always, the current Florida Healthy Kids Provider Manual is accessible at https://manuals.mcna.net/fhkc. Please contact your Provider Relations Representative with any questions.
New Clinical Practice Guidelines Now Available
Posted: January 31, 2024
MCNA has adopted new Clinical Practice Guidelines (CPGs). Our approved CPGs can be downloaded from the "Support and Downloads" page in the Provider Portal, or from MCNA's website.
2024 CDT Changes
Posted: January 19, 2024
MCNA would like to inform you about changes to CDT service codes and their nomenclature that may affect your office. The American Dental Association’s (ADA’s) updates to service codes for 2024 went into effect on January 1, 2024. Please read our provider bulletin to learn more.
Dental Details Newsletter: Winter 2023
Posted: December 4, 2023
The Winter 2023 issue of MCNA's provider newsletter, Dental Details, is now available! Check your email or download the latest issue.
In this issue:
- Holiday Greetings from MCNA
- Anxiety Reduction Tips for Your Office
- Strategies to Improve Dental Recall Appointments
- MCNA's Quality Improvement Program
- 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 often to ensure the email addresses for your office are up-to-date.
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.
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 1-855-698-6262. You can call Monday through Friday, from 8am through 8pm, EST, 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 PRDepartment@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.
Send paper claims via postal mail to MCNA at:
P.O. Box 23920
Oakland Park, FL 33307-3920
All Other Mail
Send all other postal mail to MCNA at:
P.O. Box 740370
Atlanta, GA 30374-0370