The Dental Library contains resource
material specific to the needs of dental professionals.
| Dental Manual |
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| Dental Policy |
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- View the Asuris Dental Policy Manual at: http://blue.regence.com/about/dental/
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| Forms |
Description |
Instructions |
| Provider
Change of Information Form |
Use this online form to report any changes
or additions to the provider’s demographics
or tax ID. You may also submit your NPI to Asuris
using this form. NOTE: "Tax
ID changes of Clinic Agreements may require updating
of contracts, please contact your provider representative
for clarification." Thank you. |
- Complete the old information, if applicable.
- Indicate new or changed information and submit.
|
Voucher
Overpayment Refund Form (PDF)
|
Typically, this form is used when Asuris Northwest
Health has made an overpayment to your office and
you are notifying Asuris Northwest Health of the
error and asking for a correction. |
- Complete all fields on the form.
- Complete the member information.
- Indicate the claim number and reason for deduction(s).
- Your office contact information.
- Make a copy for your records and submit a copy
to the appropriate address listed at the bottom
of the form.
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| The
Connection OnlineSM newsletter |
The
Connection Online contains information,
including updates on policies and procedures,
for physicians, dentists, other health care
and dental professionals, facilities and
their staff.
The Connection Online is published
in February, April, June, August, October and
December. Subscribe to
receive email notifications when new editions
are available. |
Other Links
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