// Payer directory

Dental insurance verification in California.

42 payers operating in California support real-time dental eligibility, on top of the 30 nationwide carriers. Every one of them verifies in seconds, with the full benefits breakdown, before the patient sits down. Valian's dental eligibility verification covers every payer listed below.

California payers with real-time eligibility

Nationwide carriers like Aetna, Cigna, UnitedHealthcare Dental, Humana and ASA GEHA verify in California too. browse the full directory.

// Plan types

California payers by plan type

Commercial payers

Medicaid payers

Medicare payers

TRICARE payer

29 of the 42 California payers list the programs they run: 14 run Commercial plans, 16 run Medicaid plans, 12 run Medicare plans and 1 runs TRICARE plans. Some run more than one. The other 13 do not list one.

By line of coverage, 4 cover dental only, 37 also cover medical and 22 also cover vision. Whatever the program, the eligibility check reads the specific plan on the patient's card.

16 payers run Medicaid plans in California

Aetna Better Health California, payer ID 128CA
AltaMed, payer ID ALTAM
Blue Shield of California, payer ID 100935
Blue Shield of California Promise Health Plan, payer ID C1SCA
Blue Shield of California Promise Health Plan, payer ID 57115
Commonwealth Care Alliance (CCA), payer ID A2793
Community Health Group, payer ID 66170
Health Plan of San Mateo, payer ID HPSM1
Inland Empire Health Plan, payer ID IEHP1
Kern Family Health Care, payer ID 77039
L.A. Care Health Plan (California), payer ID LACAR
Liberty Dental Plan, payer ID CX083
Medicaid California Medi-Cal, payer ID 100065
Molina Healthcare California, payer ID 38333
Providence PACE, payer ID 77250
SCAN Health Plan, payer ID SPSCN

// Enrollment

Enrollment with California payers

All 42 California payers run real-time eligibility with no enrollment step, so checks work from the first day.

On the payment side, 35 of the 42 send electronic remittance advice (835) only after enrollment and 7 do not offer it electronically. 20 use a one-click enrollment and 15 need a multi-step one. Typical enrollment time: a few weeks for 23, within hours for 7, a few days for 3, instant for 1 and over four weeks for 1.

For claims, 8 accept dental claims (837D) electronically, 1 more accepts them after enrollment and 21 answer claim status requests (276/277). Eligibility checks do not wait on any of it, so you can verify a patient before any of that paperwork is done.

// How to

How to verify a California patient's dental coverage

Step 1
Gather the basics.
Get the member ID from the insurance card, plus the patient's full name and date of birth.
Step 2
Pick the payer.
Match the card to one of the 42 California payers above or to a nationwide carrier. Between them, the California payers go by 135 billing names and 214 alternate payer IDs, so the card may not match the list word for word.
Step 3
Run the check.
The eligibility request goes to the payer electronically and the answer comes back in real time, with no enrollment needed first for any of the 42.
Step 4
Read the benefits breakdown.
Look at active status, deductible, annual maximum, coverage percentages and frequency limits before the patient sits down.

With Valian's dental insurance eligibility verification, your team runs all four steps from one screen for every payer on this page.

California dental payers, quick answers

How many dental payers in California support real-time eligibility?

42 payers operating in California support real-time dental eligibility, and each one is listed on this page with its own payer page. Nationwide carriers are counted separately.

Which California Medicaid dental plans can be verified in real time?

Aetna Better Health California (payer ID 128CA), AltaMed (payer ID ALTAM), Blue Shield of California (payer ID 100935), Blue Shield of California Promise Health Plan (payer ID C1SCA), Blue Shield of California Promise Health Plan (payer ID 57115), Commonwealth Care Alliance (CCA) (payer ID A2793), Community Health Group (payer ID 66170), Health Plan of San Mateo (payer ID HPSM1), Inland Empire Health Plan (payer ID IEHP1), Kern Family Health Care (payer ID 77039), L.A. Care Health Plan (California) (payer ID LACAR), Liberty Dental Plan (payer ID CX083), Medicaid California Medi-Cal (payer ID 100065), Molina Healthcare California (payer ID 38333), Providence PACE (payer ID 77250) and SCAN Health Plan (payer ID SPSCN). These 16 payers run Medicaid plans in California and support real-time eligibility.

Do nationwide carriers verify in California?

Yes. 30 nationwide carriers verify for patients in California as well, including Aetna, Cigna, UnitedHealthcare Dental, Humana and ASA GEHA. They are in addition to the 42 payers that operate in California.

Do California payers require enrollment before eligibility checks?

No. All 42 California payers run real-time eligibility with no enrollment step. Enrollment comes up on the payment side instead: 35 of them require it before sending electronic remittance advice (835).

Check any California patient in one click, before they walk in.

Plans from $39 a month per location, billed yearly, or from $49 month to month. Plus $2.50 or less per check we find — $0 when we can’t find the insurance. No setup fee and no seat fees.

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