Make an Appointment - Remote (Specialty Care)
Specialty and Other Private Sector Dental Care
Remote ADSMs must receive authorization prior to receipt of dental care for:
- Specialty care (e.g. crowns, bridges, dentures, periodontal treatment)*
- Dental care in excess of $750 per procedure or appointment
- Dental care with a cumulative total greater than $1,500 for treatment plans
- Seeing a non-network dentist
*For implant specialty services, you will also need a Command Memorandum from your unit signed by the unit commander or designated representative. NOAA Corps members must have the Command Memorandum signed by the Commissioned Personnel Center The signed memorandum must be submitted to United Concordia by the civilian dentist with the Authorization Request Form.
Authorizations are valid for one year from the date of approval. A new authorization will need to be obtained if you change dentists or dental practices.
To receive authorization, have your civilian dentist complete an Authorization Request Form. This form must indicate the procedures desired in order to initiate the authorization request. This form is available on the ADDP website in the Civilian Dentists portal for completion by the dentist. Upon authorization approval, the ADSM and civilian dentist will be notified and an appointment can be scheduled to initiate care. The determination of the authorization request can take from to three to five business days.
All necessary diagnostic information must be uploaded and submitted by the civilian dentist. If mailing the request form, all diagnostic materials must be mailed in a single package to:
- United Concordia
- ADDP Authorization Requests
- P.O. Box 69431
- Harrisburg, PA 17106-9431
If you are seen by military DTF staff (either at the DTF or at your remote location) for your exam and/or cleaning and you need to see a civilian dentist for additional treatment, the DTF staff will submit a referral on your behalf. You do not need to complete an ACN Request Form or have an authorization request submitted by the civilian dentist.