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Dentists Government

United Concordia is dedicated to helping our TDP enrollees throughout the country who have been impacted by a disasters. We realize you are wrestling with many issues and concerns in light of the current situation - your dental care shouldn’t be one of them. 

If your dental treatment has been impacted by a recent disaster, please contact United Concordia’s disaster line at 1-800-858-0051 to locate a dentist, coordinate benefits, and answer any questions regarding dental coverage. Please let us know you’ve been affected by the disasters when you call.

Contact Us - Grievance

Privacy Act Statement

This statement serves to inform you of the purpose for collecting personal information required by the TRICARE Dental Program (TDP) and how it will be used.

AUTHORITY: 10 U.S.C. Chapter 55, Medical and Dental Care; 32 CFR 199.13, TRICARE Dental Program; and E.O. 9397 (SSN), as amended.

PURPOSE: To collect information from you to manage your enrollment in the TDP, administer your benefits, and pay for the services you receive.

ROUTINE USES: Your records may be disclosed to providers of care and other business entities on matters relating to eligibility, claims pricing and payment, fraud, quality assurance, program integrity, and the coordination of benefits. Your records may also be disclosed outside of the Department of Defense (DoD) in accordance with the DoD Blanket Routine Uses published at Caution-http://dpcld.defense.gov/Privacy/SORNsIndex/Blanket-Routine-Uses/ and as permitted by the Privacy Act of 1974, as amended (5 U.S.C. 552a(b)). Any protected health information (PHI) in your records may be used and disclosed generally as permitted by the Health Insurance Portability and Accountability Act Privacy Rule (45 CFR Parts 160 and 164), as implemented within DoD. Permitted uses and disclosures of PHI include, but are not limited to, treatment, payment, and healthcare operations.

DISCLOSURE: Voluntary. If you choose not to provide this information, no penalty may be imposed, but absence of the requested information may delay or prevent your receipt of TDP services.

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Access Additional TDP Forms

  • Custodial Parent Release
  • POA
  • HIPAA Privacy Release
  • Appointment of Appeal Representative
  • File Appeal
  • Grievance
  • Fraud Complaint
  • Contact Us
  • Custodial Parent Release
  • POA
  • HIPAA Privacy Release
  • Appointment of Appeal Representative
  • File Appeal
  • Grievance
  • Fraud Complaint
  • Contact Us
  • Custodial Parent Release
  • POA
  • HIPAA Privacy Release
  • Appointment of Appeal Representative
  • File Appeal
  • Grievance
  • Fraud Complaint
  • Contact Us

Grievance Process

United Concordia is committed to providing quality outcomes through our network of dental professionals. We have a Dental Oversight Committee comprised of experienced dentists that credentials network providers every three years and monitors quality issues. Actions to correct quality issues include educational letters to providers, review of their patient records, in office review of records and examination of patients by a dental director, and termination from the network. We employ benchmark utilization reviews to ensure network dentists provide industry-standard levels of treatment. Our team of dentist advisors perform pre and post payment clinical reviews. United Concordia has well established Grievance and Appeal programs to ensure patient satisfaction and address quality concerns. If you have a quality concern regarding procedures that have been received from a United Concordia network dentist, please address them in the following manner:

    • You should address the first incident regarding clinical quality with the treating dentist to provide an opportunity to rectify the concern. If preferred, you can request that United Concordia contact the treating dentist for corrective action.
    • If the treating dentist does not correct the issue after the initial request, you should contact United Concordia to address your concerns.
    • To file a grievance, submit the online Grievance Form to United Concordia or submit a request in writing to United Concordia at:
United Concordia - TRICARE Dental Program
1800 Center Street CH2AHM-043A
Camp Hill, PA 17089

Fax: 717-635-4565

Letters should include the sponsor’s name and Social Security number or the patient’s Department of Defense Benefits Number, the patient’s name and relationship to the sponsor, the dentist’s name and address, and an explanation of the concern. United Concordia will investigate the concern, resolve it as appropriate, and notify the requestor of the results.

 
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