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Your member ID number is a unique identifier that helps protects your identity and can be found in the following places:
Your Member ID card is attached to your welcome letter; you can also obtain copies of ID cards for you and any family members who are also enrolled by logging onto the member portal, or calling 1-866-569-9900.
You are not required to register online to access your benefits, but the secure member portal will provide you with information and materials that could help you to better understand and use your dental plan. Once registered, a Member can access:
Please call our support team (toll-free) at 1-866-569-9900, Monday-Friday, 6a.m.-6p.m. Pacific Time. For TTY/TDD, press 711.
Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
Why am I not finding a DHMO member on my roster?The member may be assigned to your office and simply not on the same roster as your group DHMO clients. A copy of your roster for members with individual (non-group) coverage, should be mailed to you, but can also be generated on online by logging into the Provider Portal and selecting “Rosters” or by calling 1-866-569-9900.
How/where can I file claims?Claims can be submitted electronically, mailed or faxed. Electronic payments can be submitted through Emdeon, Tesia, or Dental Exchange.Payer ID: (Electronic Submission): GI813
Mailing Address:
Managed DentalGuard
P.O. Box 254888
Sacramento CA 95865
Fax Number: (877) 679-7197 or (916) 679-7197
Note: Only claims that do NOT require x-rays can be faxed.
The status of claims can be found online by logging into the Provider Portal; then by selecting “Claims”. You may also call 1-866-569-9900 to receive a claim status.
Can I check a member’s eligibility online?Yes, you can view the eligibility of a member online by logging into the Provider Portal and then selecting “Member Look-up”
Where can I find a DHMO Co-pay list?A Co – Pay list can be generated online by logging into the Provider Portal and hovering over the “fees & Copays” tab and select co-pay. You may also call 1-866-569-9900 to request a co-pay list be sent.
Where can I find a Fee Schedule? Fee schedules must be requested by calling 1-866-569-9900Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
How does a member pay their premium?Members can pay their premiums online by logging into the Member Portal or by calling 1-866-569-9900.
Where can I learn about my commission? To learn about commissions please call 1-866-569-9900. Where can I learn about other products Guardian Provides? To learn about guardian products please call 1-866-569-9900. Where can a Guardian member learn about the status of their claim? The member may call 1-866-569-9900 for inquiries regarding their claim status. Where can a Guardian member learn about their eligibility? The member may call 1-866-569-9900 for inquiries regarding their eligibility status.Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
How long does it take for a members account to appear on your website? The records are received and the members account will appear in around two business days. How do I change my contact information?If you need to change any of your contact information (mailing address, etc.) please visit your state exchange website.
Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
What are my options for making premium payments?Payments can be set up as a recurring monthly charge by using a credit card, debit card, or ACH bank draft. We can also accept your monthly payments made by personal check, cashier’s check, or money order.
How can I be sure that my credit card or banking information is safe?We’ve taken the proper steps to ensure that all of your transactions are managed in a safe online environment. Guardian leverages the latest technology and operational best practices to prevent your personal information from being compromised.
How can I change my billing preferences?A. If you wish to change the manner in which you make payment, you can do so online by logging into the Member Portal and selecting your name in the top right corner. Once name is selected you will click the “Billing” tab in the main body or please call 1- 866-569-9900.
When will my monthly premium payments be processed?If you pay by credit/debit card or ACH bank draft payment information will be stored and debited monthly on a recurring basis on the last week of each month prior to the month of coverage. If you pay by check or money order, you will receive a monthly invoice which must be submitted along with your payment.
Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
You can view and print your explanation of benefits by logging into the Member Portal. Once logged in you can view your Explanation of Benefits.
Where can I find of copy of the claim that my dentist submitted? You must contact member services at 1-866-569-9900 to obtain a copy of the claim. How often can I get cleanings, X-rays and other services? You can view your Limitations and Exclusions in your policy by logging into the Member Portal. When was the last time I had cleanings, X-rays and other services? You can view your frequencies by logging into the Member Portal.Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
How does my DHMO plan work?With a DHMO plan you will need to select a primary care dentist from our list of dentists participating in your plan. You can find a conveniently located primary care dental office at (link to find a provider). If you have family members covered under your plan, they can each select their own primary care dentist. You will need to see your selected primary care dentist for all dental services. When necessary, your primary care dentist will refer you to a participating specialist who will complete specialty services. As a DHMO member you will only be responsible for the co pays associated with each covered service along with your office visit co pay. There are no deductibles or maximums under your plan and no claims to file.
If you want to change your primary care dentist, you may do so by calling 1-866-569- 9900. If the Plan receives the request by the 20th of the month, the effective date of the change will be the first day of the following month. Any services started at one dental office must be completed by that office, and your account with the first office must be paid in full before a transfer can be processed.
DHMO plans are only offered in select states.
A PPO plan allows you to visit any licensed dentist to receive your dental care. You do not need to select a primary care dentist and you do not need a referral to see other providers. If you receive care from a dentist that participates in the Guardian network, you may be reimbursed at a higher level than if you received care from a dentist that does not participate. Additionally, dentists participating in the Guardian network charge discounted fees, with an savings up to 35%. So the best way to save money is by visiting a dentists that participates in the Guardian network!
If you visit a dentist that participates in the Guardian network, there are no claims to file, the dentist will submit the claim on your behalf and there is no need for referrals before visiting specialist. Guardian has an easy to use tool to help you find a dentist. You can start by following the easy steps to search for a participating provider in your area and remember each member of your family may select their own dentist. Click here to find a Provider and select PPO.
Your out of pocket costs for dental services will depend on the plan you have selected, where you live, and the complexity of the procedures you receive
If you are enrolled in a DHMO plan, you can obtain a complete list of services and cost for your selected plan by viewing your policy online. If you have not registered online you can get started clicking the clicking here. Once complete, you can find your policy information by clicking the “benefits tab”. You can also call 1-866-569-9900 to speak to one of our customer services representatives.
You can see an estimate of costs of typical dental procedures by viewing our dental cost estimator tool. Please see your plan details for the reimbursement level for the various procedures
We are always looking for great new dentist to join our network. You can speak with your dentist asking that they contact us to participate in our network. This process can be time consuming and in the meantime it would be best to select a primary care dentist who is already participating so you can be seen immediately
If you are in a DHMO (In network only plan), only care received by a participating dentist will be covered under the plan. If you are in a PPO plan and you visit a dentist that is not participating in the Guardian network, you may receive reimbursement, but at a lower rate that had you visited a dentist that participates in the network.
You can use the online “Find a Dentist” tool to find a specialist, your primary care dentist may be able to provide you with a list of specialists that participate in the network, or you can call 1-866-569-9900 and request one from our customer service specialists.
Visit www.guardiananytime.com to manage your account.
Need help with specific issue? We just may have the answer for you here! If you still have questions, you can contact us using the information below.
Visit www.guardiananytime.com to manage your account.
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