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Principal® dental provider update: cybersecurity incident impacts processes, alternative options available
Like many dental practices, the cyber security incident that occurred with Change Healthcare is impacting normal processes at Principal. This event has disrupted certain applications and systems used to service our dental insurance business. We continue to work closely with Change Healthcare to understand the extent of the event. At this time, we have no evidence that our customer data has been compromised. We have also suspended our connections until the cyber event has been resolved.
Please see below for information on the ways in which we seek to continue to serve provider needs during this time of disruption.
Submitting claims
- In addition to Change Healthcare, Principal actively participates with Dental Xchange and Vyne to receive electronic claims. If claims are submitted through either of those clearinghouses, the claims submission process is fully operational.
- For offices that rely solely on Change Healthcare, Principal has created an opportunity for providers to upload claim forms directly to our website, Principal.com/dental-providers. Log in and search for your patient, then select the Submit a claim button. You will be able to upload your claim form and any additional supporting documents such as images or PDFs.
- Claims can also be submitted via paper. Mail the claim form to PO BOX 10357, Des Moines, IA 50306-0357.
Resubmission of attachments
- In some cases, we may need you to resubmit attachments. You will be notified if there is an issue with the attachments that were submitted. Those attachments will need to be resubmitted as requested in our notification or through another provider portal.
Claim payments
Principal leverages Change Healthcare to assist with issuing payments to providers. Based on the cyber security incident, we have made the decision to temporarily send all payments as paper checks. If you have questions or concerns regarding past or future payments, access Principal.com/dental-providers to view claim payment information. Use the automated Chat feature 24/7 or log in and search for your patient, then select Claims. You may also contact us at 800-247-4695.
Benefits and eligibility
Access Principal.com/dental-providers to view a full benefit summary and eligibility information. Use the automated Chat feature 24/7 or log in and search for your patient, then select Eligibility and Benefits. You may also contact us at 800-247-4695.
When you have a patient with dental insurance from Principal®, we’re here to help make that experience as easy as possible. Leverage our online Provider Service Center to make your job easier. And watch these videos to see all the ways you can self-serve.
To access the Provider Service Center, you’ll need to register for an account. Once you have that, you can log in at any time to:
- Check patient eligibility and coverage, including coinsurance, deductibles, benefit maximums, tooth history, network membership, and benefits in effect on a given date.
- Determine if your patient is eligible for an exam, cleanings, X-rays, and other major services.
- View, request, and print benefit summaries online.
- Submit a pre-determination.
- Request a copy of the fee schedule.
- View the explanation of benefits (EOB) online.
- Submit additional information needed to complete claim processing.
Before treatment begins, you can request an optional pre-determination of payable benefits. Simply collect the following information:
- ADA codes for the procedure(s)
- Billed charge
- Supporting X-rays/information
Then submit it to us using one of the following methods:
- Log in to the Provider Service Center.
- Email us at CSDClaims@exchange.principal.com
- Mail the information to:
Principal
PO Box 10357
Des Moines, IA 50306-0357
Once the pre-determination is processed, it’s viewable in the Provider Service Center. You’ll also receive a written response within 15 business days. A pre-determination doesn’t expire if nothing has changed (i.e. plan changes, significant changes in mouth history, treatment plan changes, etc.).
You can submit the ADA standard claims form to us using one of the following methods:
- File electronically by using one of the clearinghouse options (details below):
- Email us at CSDClaims@exchange.principal.com
- Mail the information to:
Principal
PO Box 10357
Des Moines, IA 50306-0357
Please use the privacy ID only. Claims submitted with a Social Security Number won’t be accepted.
Once the claim is processed, the explanation of benefits (EOB) is viewable in the Provider Service Center. The EOB shows:
- Adjustments to charges you need to make to your records.
- Amount due from the patient, such as coinsurance and deductible, if any.
Dental claims will only be considered if received within 12 months of the date of service. Orthodontia claims will only be considered if received within 36 months of the date of service.
Submit additional information needed to complete claim processing or to appeal a claim decision by logging in to the Provider Service Center. You can also use the same email or mailing address listed above.
Leverage these clearinghouses to save time, increase claim accuracy, and get paid faster. Our payor number is 61271 for the following options:
- Tesia Clearinghouse, LLC: tesia.com, 800-724-7240 or info@tesia.com
- Vyne Dental: vynedental.com, 800-782-5150.
- DentalXChange: dentalxchange.com, 877-932-2567 ext. 452 or support@dentalxchange.com
Resources
Claim resolution guidelines
View the process we follow when there is insufficient claim information.
Principal clinical guidelines—at your fingertips
Easily find guidelines for frequently submitted procedures that require review — and what you need to submit.
Have a question?
Reach us by phone
Monday-Thursday: 7:30 a.m. to 6:30 p.m. (CST)
Friday: 7:30 a.m. to 6:00 p.m. (CST)
Benefit verification: 800-247-4695