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MICHIGAN PROVIDERS

Treating Blue Cross Blue Shield of Michigan Members

Enrolled in Blue Dental, Healthy Kids Dental and Medicare Advantage plans

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Healthy Kids Dental appointment and timely access to care standards

Please schedule your HKD patients within the timeframes outlined below

  • Emergency appointments: Immediately, 24/7
  • Urgent appointments: Within 48 hours
  • Routine appointments: Within 21 business days 
  • Preventive appointments: Within six weeks 
  • Initial appointments: Within eight weeks 
     

Attention: Blue Cross Healthy Kids Dental Providers

You must verify eligibility on the date of service to ensure reimbursement, since membership can change frequently. We recommend establishing a process to check eligibility on appointment days using the provider portal.

Dental Homes for Blue Cross Healthy Kids Members

Dental Homes for Healthy Kids Dental patients help build strong relationships between them and their dental care provider. Assignments can be made only to an actively participating dentist.

 

Eligible members can change their assigned dental home at any time and do not have to be assigned to your office to receive treatment. You will be reimbursed for care delivered to a Healthy Kids Dental patient even if they are not assigned to your office at the time of treatment.

Live Training Schedule

Interested in learning more about the connection between dental care and whole health? Join Blue Cross Blue Shield of Michigan and the University of Michigan’s Center for Health Research Transformation on Tuesday, October 29th at 12 p, for “Heads Up! The importance of oral care to overall health.”

The University of Michigan designates this webinar for one continuing education credit. This is a free, one-hour course, click here to register.

Join us for our upcoming Network Webinars and Micro-Learning sessions. View the invite to learn more and to register.

Micro-Learning Network Series

You are cordially invited to join our exciting new micro-learning webinar series. These webinars are approximately 15 minutes, making them perfect for your lunch break. Expand your knowledge with fresh subjects or deepen your understanding of familiar topics. Come learn and grow with us!

Claim Submission

You may submit your claims one of three ways:

  1. Clearinghouse: Payor ID BBMDQ
    • NOTE: Payor ID is for Blue Dental, Medicare Advantage and Blue Cross Healthy Kids Dental
  2. Provider portal: Provider portal for electronic claims submission and eligibility verification for Blue Dental, Medicare Advantage and Blue Cross Healthy Kids Dental members
  3. Paper Claims can be mailed to:
    • For Blue Dental and Medicare Advantage claims
      Blue Cross Blue Shield of Michigan
      Attn: Claims
      PO Box 49
      Detroit, MI 48231
    • For Blue Cross Healthy Kids claims
      Blue Cross Blue Shield of Michigan
      Attn: Claims
      PO Box 491
      Milwaukee, WI 53201-0491

Get Paid Faster with Direct Deposit

Electronic Funds Transfer (EFT) which is commonly referred to as direct deposit, is the fastest, easiest and safest way to receive your claim payments. After a claim is successfully submitted, funds will be deposited within 3 business days. Your remittance will be available online in the Provider Web Portal and no longer mailed to you.

How to Enroll

  1. Log in to the provider portal provideraccess.dentaquest.com
  2. Not registered? Register here
  3. From the main menu, select Manage Practice → EFT. Fill out the form, upload a copy of a voided check with your banking information and submit.

You will receive a confirmation notification with a Request Number after successfully completing the form. Please allow up to five business days for processing.

Reporting Fraud, Waste & Abuse or Misuse of Services

Blue Cross and DentaQuest are committed to detecting, reporting, and preventing potential fraud and abuse. To report an incident, call 800-237-9139.

 

To report Medicaid fraud and abuse:

  • Call 855-MI-FRAUD or 855-643-7283
  • Visit michigan.gov/fraud and click on File a Complaint – Medicaid Complaint Form
  • Write to the Inspector General at
    Office of Inspector General
    PO Box 30062
    Lansing, MI 48909
Preventistry Pulse

PREVENTISTRY PULSE

The newsletter designed for anyone who wants to improve oral health for themselves, their families, customers or communities.