Due to staffing shortages throughout the nation, you may experience longer wait times when calling our Blue Dental customer service line. We are working diligently to add the necessary team members to ensure minimal wait times.
Our busiest times of the week are Monday and Tuesday between 9:00 am – 3:00 pm EST.
Self-service channels are available 24x7, including our provider web portal and IVR phone system, which are designed to resolve many of your requests without the need for agent-assisted customer service.
Starting in October, Michigan dental offices are required to send prescriptions to pharmacies with an ePrescription format. On Oct. 1, 2021, prescriptions can no longer be handwritten, phoned in, or faxed to pharmacies.
We target opioids that are most likely to be abused, with such tools as prior authorization, refill restrictions and quantity limits to help prevent stockpiling and excessive quantities of pain pills. We limit coverage of opioid prescriptions to a 30-day supply per fill.
Our pharmacists monitor claims to identify members receiving a dangerous and highly addictive drug combination commonly referred to as the “triple threat” and take necessary action. This combination of opioids, benzodiazepines and Soma®, taken together, can slow or even stop a person’s breathing.
We apply algorithms to integrated pharmacy and medical claims data to identify prescribers, pharmacies and members with above-average opioid prescriptions or use for appropriate action.
Our opioid and heroin overdose pilot program uses real-time hospital discharge data to enable quick intervention. Behavioral health experts engage members in treatment following an overdose and inform them of available resources.
Blue Cross is working with doctors, pharmacies, community organizations, policy makers, public health advocates, foundations and employers to fight this epidemic. As a result of these partnerships, we’re making opioid use safer, providing more information to help prevent addiction and arming communities to fight back.
Blue Cross makes significant efforts to educate and inform the public about how to get rid of unnecessary medications, including sponsoring drug take-back kiosks at select Walgreens locations.
According to the Commonwealth Fund, drug overdose deaths in the United States increased during the pandemic and hit a record high of 93,331 in 2020, with elevated levels continuing through the end of the year. As health care professionals, we all play a part in solving this problem and, unfortunately, we still have more work to do. As dentists, please help us spread the word about safe drug disposal days and continue to use the Michigan Automated Prescription System to assess patient risk and prevent drug abuse.
Dental providers can administer COVID-19 vaccinations in their office for Blue Cross members, using their Medical PIN and a medical claim form. The COVID-19 vaccine billing document provides medical codes and other detail. Please note that dental claim forms are not acceptable and will not be processed nor reimbursed.
Blue Cross has extended the timeframe for providers to appeal claims from 60 to 180 days.
When you accept Medicare Advantage BlueDental PPO, you also accept Medicare Advantage BCNA (the HMO). Questions? Contact Blue Dental Medicare Advantage customer service at 1-844-876-7917.
My patient asked me if I am a Tier 1 provider with Blue Cross. What does this mean?
Recently, Blue Cross Blue Shield of Michigan changed the way we refer to our participation levels for providers.
A Tier 1 provider is in our Blue Dental PPO Network by having signed a contract with one of our leased network partners. A Tier 1 provider is in network and would be able to see all Blue Dental members with EPO plans or PPO dental plans.
A Tier 2 provider is out of network but agrees to participate and accept our Tier 2 fees on a per claim basis, also known as Blue Par Select. By signing a Blue Cross issued check for Blue Dental services rendered, the provider agrees to accept reimbursement as payment in full, with no balance billing to the member.
If a member hands my office manager a Blue Cross Blue Shield of Michigan medical card and says they have dental coverage, what is the best way to determine if I can see that patient in my office and get reimbursed?
To determine if your patient is a Blue Dental member:
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
