Are referrals required for Decent plans?
Good news! Referrals are no longer required for Decent's plans as of January 1, 2022. You do not need to submit a referral to us for any specialist care needed for our members. However, members must still see their designated primary care provider first before seeing any specialists so that you can help coordinate their care.
Review our Reimbursement Policies
Review Decent’s > Provider Manual
Decent highly recommends that providers submit claims electronically via your billing software and clearinghouse of choice using Decent’s Electronic Payer ID: DECENT
If you are having any issues submitting claims to Decent electronically, please contact your billing vendor to ensure they have Decent’s Payer ID in their system. Our clearinghouse is Healthcare IP.
If a claim cannot be submitted electronically, a paper UB-04 or CMS-1500 should be submitted to:
P.O. Box 4366
Seattle, WA 98194-0366
Decent supports the following EDI Transactions
Type (Ansi v5010) Description 270/271 Eligibility Request and Response 276/277 Claim Status Inquiry and Response 835 Remittance Advice 837 Health Care Claim
How to Credential / Contract with Decent
We are excited that you want to join Decent’s network. We are always looking to grow our network in Texas, and will expand to other states soon. Please reach out if you’re interested in joining us.