Providers

Dominion Dental Services USA, Inc. (Dominion) is the administrator for the Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. (Kaiser Permanente) Dental Plans effective January 1, 2008. 

There are two forms that must be completed by your office and returned to us in order to participate in the Kaiser Permanente Dental Plans. These are our credentialing form and our standard "Dental Provider Agreement." We also need a copy of your dental license, malpractice insurance coversheet, DEA certificate and any post-graduate information and board certification (for specialists). The forms are available by clicking on the appropriate link under your state of practice. Simply print the forms, fill them out and return them to our office. A Dominion representative will contact you shortly to explain the details, coordinate the delivery of our provider manual and specialty care guidelines and answer any questions you have regarding this transition.

POS/PPO Members should be charged according to the plan’s “POS” Plan fee schedules, which are available Above. Claim reimbursement will follow your same Dominion contracted PPO fee schedule and claims will be processed in the same manner as our typical PPO business.
 

Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. is licensed as a Health Maintenance Organization in Virginia, Maryland and the District of Columbia.