MICHIGAN PROVIDERS
The Michigan Department of Health and Human Services and Blue Cross Blue Shield of Michigan have teamed up for the Healthy Kids Dental program — dental coverage at no cost to Michigan children under 21 on a Medicaid plan.
Are you currently a participating provider or interested in becoming one, click here for our Frequently Asked Questions.
Join the Healthy Kids Dental Network
First, get credentialed.
- Complete the online credentialing application
- Sign up with the Council for Affordable Quality Healthcare (CAQH)
If you’ve already started the application process, you can continue here.
Second, enroll in CHAMPS.
- Visit the MiLogin website and login or create an account
- Once your account is created, select subscribe to CHAMPS
If you need assistance with enrollment, contact the Medicaid Provider Help Line at 800-292-2550 or providerenrollment@michigan.gov.
Access the Provider Portal
You must verify patient eligibility through the provider portal on the date of service to ensure reimbursement since membership can change frequently.
Claims, Contacts, and Other Resources
You may submit your Healthy Kids Dental claims through:
- The Provider Portal
- Clearinghouse with payor ID: BBMDQ
- Mail to: Blue Cross Blue Shield of Michigan, Attn: Claims, P.O. Box 491, Milwaukee, WI 53201-0491
For general support, including claim submission help, contact provider servicing at 844-876-7917. For credentialing assistance, contact 800-233-1468.
Download the benefits summary to see benefits available to Healthy Kids Dental members.
Download the office reference manual.
Download the Resource Guide.
Your Dental Home Roster
Dental homes help build strong relationships by establishing a rapport, routine and care between you and your Healthy Kids Dental patients. As a dental home, you will have access to your member roster that you can use to outreach to patients to encourage a dental exam. Additionally, providers can earn incentives throughout the year for servicing members on their roster.
Dental home assignments are made only to actively participating dentists. Healthy Kids Dental patients can change their assigned dental home at any time. Patients don’t have to be assigned to your office to receive treatment. You’ll be reimbursed for care delivered to a Healthy Kids Dental patient even if they aren’t assigned to your office at the time of treatment.
To access your Healthy Kids Dental roster, please visit the provider portal.
Download the roster lookup guide here.
Care Standards
Fee Schedule and Reimbursement
Reimbursement to participating dentists for covered services rendered to members is based on the Blue Cross Healthy Kids Dental fee schedule.
All covered services for eligible members are reimbursed at 100 percent of the dentist’s submitted fee or the amount in the HKD fee schedule, whichever is less. Balance billing for any difference between the dentist’s regular fees and the amount in the current fee schedule is not permitted.
Procedures that don’t appear on the Blue Cross Healthy Kids Dental fee schedule are not a covered benefit. The dentist must discuss the member’s responsibilities in advance of treatment. Treatment for noncovered services should only be rendered following agreement with the member’s or responsible party’s approval with clear understanding of financial responsibility and the decision documented in the patient record.
Due to Medicaid requirements, any services that are denied by Blue Cross Healthy Kids Dental may not be charged to the member or responsible party unless the member or responsible party has agreed to pay for it.
For more information, please download the office reference manual.
Get Paid Faster with Direct Deposit
Electronic Funds Transfer (EFT) or direct deposit is the fastest 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 portal.
To enroll, login to the provider portal. From the main menu, select Manage Practice > EFT. Follow the prompts, including uploading a copy of a voided check, and submit.
You will receive confirmation of your request after successfully completing the form. Please allow up to five business days for processing.
Reporting Fraud, Waste & Abuse or Misuse of Services
Blue Cross is committed to detecting, reporting, and preventing potential fraud and abuse.
To report a fraud, waste, abuse or misuse incident:
- Call Blue Cross at 800-237-9139 or
- The State of Michigan at 855-MIFRAUD (643-7283)
- Anonymous hotline: 866-654-3433
- Fax: 262-241-7366
- Visit michigan.gov/fraud and select File a Complaint – Medicaid Complaint Form
- Write to the Inspector General at:
Michigan Department of Health and Human Services
Office of Inspector General
P.O. Box 30062
Lansing, MI 48909
PREVENTISTRY PULSE
The newsletter designed for anyone who wants to improve oral health for themselves, their families, customers or communities.