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GEHA (Government Employees Health Association) forms are essential documents for healthcare providers, particularly dental professionals, seeking to join or maintain status within the Connection Dental Network. This category covers the critical paperwork required to establish a formal relationship with one of the largest national dental PPO networks. These forms ensure that providers meet the necessary credentialing standards, covering everything from professional education and state licensing to malpractice coverage and work history. Proper documentation is a prerequisite for receiving reimbursement and adhering to network fee schedules.

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Connection Dental Provider Application (V11.2025) · Filled by Instafill.ai in 1 min 13 sec

Connection Dental Provider Application (V11.2025) filled by Instafill.ai

About GEHA forms

Typically, these forms are utilized by dental practitioners, office managers, and credentialing specialists during the enrollment or re-credentialing process. Whether a practice is expanding its patient base by joining the network or a new dentist is being added to an existing group, accurate documentation is vital. Completing packets such as the Provider Application and Participating Provider Agreement requires detailed information, including NPI details, DEA registrations, and five-year work histories. Because these documents are scrutinized during the evaluation process, any errors or omissions can lead to significant delays in credentialing approval.

Managing this volume of administrative data can be time-consuming, but tools like Instafill.ai use AI to fill these forms in under 30 seconds while ensuring data accuracy and security. This allows dental offices to focus more on patient care rather than the complexities of manual data entry for credentialing paperwork.

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How to Choose the Right Form

If you are a dental professional looking to partner with the Government Employees Health Association, Inc. (GEHA), selecting the correct documentation is the first step toward joining one of the largest dental networks in the country. While our current listing focuses on the primary onboarding packet, it is important to understand how this document serves your practice.

Joining the Connection Dental Network

The primary document in this category is the Connection Dental Network – Provider Application (GEHA Connection Dental Network) and Participating Provider Agreement. This is a comprehensive, dual-purpose packet designed for dentists and specialists who wish to become part of the CONNECTION Dental Network PPO. You should choose this form if you fall into any of the following categories:

  • New Providers: If you have never been part of the GEHA network and need to undergo initial credentialing and enrollment.
  • Contracting Practices: If you are establishing the legal and financial terms of your relationship with GEHA, as the packet includes the formal Participating Provider Agreement.
  • Re-credentialing: If you are required to update your five-year work history, malpractice insurance details, or state licensing information to maintain your active status.

Key Requirements for a Successful Submission

To avoid delays in your credentialing approval, ensure you have the following information ready before you begin filling out the Connection Dental Network – Provider Application:

  • Professional Credentials: Your NPI, state licenses, DEA/SDC details, and a complete education/training history.
  • Employment History: A full five-year work history is required; be prepared to provide written explanations for any gaps in employment to prevent the application from being returned.
  • Insurance & Practice Data: You will need your current malpractice coverage limits and specific practice location data where you will be seeing patients.

By using the AI-assisted tools on Instafill.ai, you can ensure that this complex application is completed accurately, helping you secure your spot in the network and begin accepting GEHA patients more quickly.

Form Comparison

Form Purpose Who Files It Key Requirements Frequency/Timing
Connection Dental Network – Provider Application (GEHA Connection Dental Network) and Participating Provider Agreement Credentialing and contracting dentists for participation in the GEHA dental network. Dental providers seeking to join the CONNECTION Dental Network PPO. NPI, state licenses, five-year work history, and malpractice insurance coverage documentation. Filed during initial enrollment or when re-credentialing is required by the network.

Tips for GEHA forms

Gather All Credentialing Documents Before Starting

Ensure you have your NPI, state licenses, DEA certificates, and current malpractice insurance details ready before you begin. Having these documents on hand prevents interruptions and ensures you can fill out every section of the GEHA application accurately.

Provide Clear Explanations for Work History Gaps

GEHA requires a continuous five-year work history for credentialing purposes. If there are any gaps in your professional timeline, be sure to provide a brief but clear explanation to avoid follow-up requests or significant processing delays.

Verify Practice Location and Tax ID Information

Double-check that the practice address and Tax Identification Number (TIN) match your official IRS records. Inconsistent location or tax data is a common reason for application rejection or issues with future network reimbursement.

Review the Participating Provider Agreement Terms Carefully

Before signing, thoroughly read the contractual terms regarding reimbursement, fee schedules, and compliance obligations. Understanding these provisions upfront ensures your practice is fully prepared for the administrative requirements of the Connection Dental Network.

Use AI Tools to Accelerate Form Completion

AI-powered tools like Instafill.ai can complete these complex GEHA forms in under 30 seconds with high accuracy. Your sensitive professional data stays secure during the process, making it a major time-saver for busy dental practices managing multiple enrollments.

Ensure All Professional Questions Are Answered

The application includes several professional conduct and attestation questions that must be answered truthfully and completely. Leaving any of these fields blank or providing vague responses can trigger a manual review and stall your credentialing approval.

Frequently Asked Questions

Who is required to complete the GEHA Connection Dental Network forms?

These forms are designed for dental providers who wish to become participating members of the CONNECTION Dental Network PPO. Both individual dentists and dental practices must complete the application and the provider agreement to be credentialed and eligible for network reimbursements.

What documentation should I have ready before starting the GEHA provider application?

You should gather your National Provider Identifier (NPI), state licenses, DEA and SDC certificates, and proof of current malpractice insurance. You will also need a detailed record of your education, professional training, and a complete five-year work history.

Can I fill out GEHA forms using AI?

Yes, AI tools like Instafill.ai can be used to complete GEHA provider applications and agreements by automatically extracting information from your professional documents. This technology ensures that data from your CV or license records is accurately placed into the PDF fields in under 30 seconds.

How long does it take to fill these forms online?

While manual entry for complex credentialing forms can take an hour or more, using an AI-powered platform significantly speeds up the process. Platforms like Instafill.ai can process and populate these forms in less than 30 seconds, allowing for a much faster submission.

Why is a five-year work history required for the GEHA application?

GEHA requires a continuous five-year work history to maintain strict credentialing standards for their network. If there are any gaps in your employment during this timeframe, you must provide a written explanation for each period of inactivity to avoid processing delays.

What is the difference between the Provider Application and the Participating Provider Agreement?

The Provider Application is used for the credentialing process to verify your identity, education, and professional standing. The Participating Provider Agreement is the legal contract that defines the business relationship, including fee schedules, compliance rules, and termination protocols.

What are common reasons for a delay in GEHA credentialing?

Delays are most often caused by incomplete applications, missing signatures, or expired supporting documents like state licenses or malpractice insurance. Ensuring that all work history gaps are explained and that the attestation page is signed will help streamline the approval process.

Do I need to submit a separate application for each practice location?

The application typically allows you to list multiple practice locations where you will be providing services under the network. However, you must ensure that your malpractice coverage and state licenses are valid for all locations listed in the document.

How does GEHA verify the information provided in the application?

By signing the attestation and authorization section, you grant GEHA the right to contact primary sources to verify your education, licensing, and professional history. This verification process is a standard part of the PPO network's quality assurance and credentialing protocol.

Where should I send the completed GEHA dental network packet?

Once the application and agreement are filled out and signed, they should be submitted to the GEHA Connection Dental Network's credentialing department. Submission methods usually include secure email, fax, or standard mail as specified in the application's cover instructions.

Glossary

GEHA
The Government Employees Health Association, a self-insured, not-for-profit association that provides medical and dental plans for federal employees, retirees, and their families.
Credentialing
The formal process of verifying a dental provider's professional qualifications, including education, licensing, and work history, to ensure they meet network standards.
Connection Dental Network
A nationwide Preferred Provider Organization (PPO) dental network managed by GEHA that connects independent dentists with various insurance payers.
NPI (National Provider Identifier)
A unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS).
Participating Provider Agreement (PPA)
A legal contract that outlines the terms, reimbursement rates, and responsibilities a dentist must follow when joining the GEHA dental network.
PPO (Preferred Provider Organization)
A type of insurance plan that encourages members to use a specific network of providers who have agreed to provide services at lower, pre-negotiated rates.
DEA/SDC Number
Registration numbers issued by the Drug Enforcement Administration or State Drug Control that authorize a provider to prescribe controlled substances.
Malpractice Coverage
Professional liability insurance that protects healthcare providers against claims of negligence or errors made during the treatment of a patient.