About Healthplex

Healthplex is known as "The Dental Plan Specialists." The company was established in the 1970's by dentists and other healthcare professionals who were concerned about the increasing costs of dental care. With an understanding of dentistry as well as dental insurance, Healthplex was able to develop benefit plans that effectively managed the risks associated with conventional indemnity plans. One million subscribers later, the corporation is providing dental benefits and administrative services for insurance companies, HMOs, school districts, municipalities, welfare funds and businesses of all sizes.

In New York, dental plans are underwritten by Dentcare Delivery Systems, Inc., a not-for-profit Health Services Corporation, Healthplex Insurance Company, the United States Life Insurance Company and other licensed organizations. In New Jersey, benefits are available through our wholly owned Dental Plan Organization, International Healthcare Services, Inc. In addition to dental benefits and administrative plans, Healthplex maintains one of the largest Preferred Provider Organizations in the Northeast. The company is also certified as a Credentials Verification Organization in ten out of ten credentialing elements by the National Committee for Quality Assurance. The National Committee for Quality Assurance is an independent, non-profit organization that certifies credentials verification organizations and accredits managed care organizations.

SERVICES PROVIDED

Insured Plans
° Various Deductibles and Maximums
° Scheduled and UCR Based Programs
° Choice of Dentists
° Preferred Provider Organization Available

Managed Care Group Dental Plans
° Participating Dentist Networks
° Low Co-payment Plans
° No Deductibles or Waiting Periods
° Specialty Care Included

Individual And Small Group Plans
° Voluntary Programs
° No Minimum Participation Requirement
° No Exclusions for Pre-existing Conditions
° Extensive Provider Network

Third Party Administration
° Plan Development and Design
° Professional Review of Claims
° Correspondence with Providers
° Predetermination of Claims
° Claims Adjudication
° Coordination of Benefits
° Generation of Explanation of Benefits Forms
° Mailing of EOB's and Checks
° Maintenance of Claims History
° Utilization Review and Reporting
° Multi-lingual Customer Service Department
° Personal Identification Cards

Provider Networks and Credentialing
° NCQA Certified Credential Verification Organization in 10 out of 10 elements
° Primary Source Verification
° National Practitioner Databank Review
° Malpractice History Review
° Provider Site Audits

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