Why Choose Healthplex  

Leadership in Dental Plans

  • Evidenced by over two million enrollees who receive comprehensive dental benefits through the Healthplex system.
  • Confirmed by over thirty years with the same management team.
  • Supported by a wide array of dental products including:
    • Fully Funded Plans
    • Third Party Administration
    • Network Development and Maintenance
    • Credentialing
    • Quality Assurance Programs.
  • Verified by our clients for whom we have stabilized premiums and applied the most efficient cost containment practices in the industry.

Healthplex has worked hard to earn its reputation for professionalism, commitment and adherence to the highest standards. Our dedicated staff is always responsive to the needs of our client groups, members and providers. We have demonstrated flexibility in plan design so that you get the most out of every benefit dollar you have to spend. By combining our expertise with current technology we have been able to provide quality care while saving significant dollars for our clients.

Our Network of Dentists
Our provider networks are a key component to our dental programs. We recognize the value of a strong relationship with the dental community and always attempt to balance the needs of dentists with those of our members. Because of this our panels are consistently expanding. We offer dentists access to a wider patient base and we offer enrollees superior access to care.

All participating providers must meet rigid professional requirements, such as:

  • Proper credentials including license in good standing, appropriate educational background and review of malpractice history
  • Office cleanliness
  • Sufficient and qualified staff
  • Modern equipment
  • Standardized infection controls
  • Commitment to prevention

As a part of our Quality Assurance Program, all participating dentists are screened and monitored by our provider relations professionals using on-site inspections and evaluation of patient records. These controls are designed to guarantee full satisfaction to your membership.

Credentials Verification Organization
Outsourcing the administrative burden and associated costs of credentialing to a Credentials Verification Organization (CVO) is a very popular practice in today's healthcare industry. Healthplex has been credentialing providers for major HMOs, insurance companies, labor unions, municipalities, and private companies for over 20 years. The Healthplex CVO is the qualified alternative to "in-house credentialing."

Healthplex CVO is dedicated to providing quality management and distribution of accurate credentialing information to our clients. It is our goal to collect and verify this information in accordance with the guidelines established by the National Committee for Quality Assurance (NCQA)* and to provide this information to our clients in the timeframes required by NCQA.

Healthplex CVO is certified by NCQA for ten out of ten credentialing elements.

*NCQA is an independent, non-profit organization that certifies credentials verification organizations and accredits managed care organizations.

Claims Review
Under sophisticated computer technology, Healthplex processes and tracks your claims with the shortest turn-around time in the industry.

Highly trained processors, with an average claims handling experience of ten years, staff the Claims Department. Included are a number of dentists and hygienists who enable us to determine the appropriateness of treatment according to contract specifications, and long-term health benefits to the patient.

With Healthplex, your organization will receive quality plan administration coupled with professional expertise and cutting-edge computer technology. It's the winning combination your plan deserves.

Customer Service
Healthplex takes great pride in its Customer Service Department. Friendly and well trained customer service representatives are available to respond to any and all of our clients' needs Monday through Friday from 8:00am - 6:00pm. In addition we have an emergency hotline available 24hours a day, seven days a week. We have Spanish, Russian, Cantonese and Mandarin representatives in house, and we are able to immediately access interpreters in just about any language through our always-on-call language interpretive service. No matter what type of call our customer service representitives receive, we are always there to answer your questions and help you solve your problems - and always with a smile!

100 years ago 50% of adults in North America were toothless.