Blue Cross Blue Shield of MI Dentist Page
Important Information about BlueCross BlueShield of Michigan
The Blue Cross Blue Shield of Michigan Dental Provider Manual was updated November 2021 and is now available. Please click the link below to review it.
Click here for the BCBSM Provider Manual
Additional Resources:
Click here to register and login for the BCBSM Provider Portal
Click here for information regarding BCBSM Portal Training and Orientation
Click here for the BCBSM Provider Summary Guide
Dental Home for BCBSM Healthy Kids Members
The Purpose of a Dental Home is to build a strong relationship between patients and their primary care dental provider. The program is designed to send members a post card identifying their Dental Home and ways to change it, if desired. Members do not have to be assigned to your office to receive treatment however, they must be eligible, and you must be actively participating in the plan for reimbursement. Members will not be assigned to specialist other than Pediatric Dentist for the BCBSM Healthy Kids plan. Member rosters can be found on the provider portal at provideraccess.dentaquest.com.
New for 2022 – BCBSM Healthy Kids Dental Broken Appointment Program
BCBSM Healthy Kids Dental now has a broken appointment program. This program focuses on educating and rescheduling patients who have missed a dental appointment. To learn more about this program please refer to the provider web portal for further information.
Blue Cross Blue Shield of Michigan Commercial Dental Plans Payment Information
Attention BCBSM and BCN Commercial Providers: If you wish to receive electronic BCBSM payments you must contact DentaQuest. Information and forms to sign up for EFT are available here: http://dentaquest.com/state-plans/regions/michigan/dentist-page/eft-direct-deposit/, you may also sign up directly through the provider portal at provideraccess.dentaquest.com.
Attention BCBSM Healthy Kids Dental Providers
Verification of eligibility on the date of service of each BCBSM HKD member is essential as eligibility for these members may change frequently. If you do not check eligibility on the date of service for a BCBSM HKD member before you begin treatment, and deliver services to an ineligible member, you cannot receive reimbursement from BCBSM and cannot bill the member for the services. If you have not already done so, please set up a process where you check BCBSM HKD member eligibility on their appointment days. To check eligibility via the BCBSM provider portal, visit provideraccess.dentaquest.com.
Please refer to the BCBSM Healthy Kids Dental Office Reference Manual for covered benefits and important information about this plan.
MI BCBSM Healthy Kids Dental Office Reference Manual update
The BCBSM Healthy Kids Dental Office Reference Manual has been updated, effective 01/03/2023. Please visit the "provider resources" section to review the new ORM in detail.
CHAMPS notice:
All BCBSM Healthy Kids Dental providers who serve BCBSM Healthy Kids dental beneficiaries are required to enroll in CHAMPS in order to receive payment from the Dental Health Plan.
For dates of service on or after January 1, 2019, MDHHS will prohibit contracted Medicaid Health Plans and Dental Health Plans from making payments to providers not actively enrolled in CHAMPS. Please take immediate action to enroll in CHAMPS or renew your enrollment if it has expired. You must revalidate your information with CHAMPS every 5 years.
To enroll in CHAMPS:
To review instructions on this process:
If you have any questions or need assistance with enrollment, please contact the Medicaid Provider Help Line 800-292-2550 or email ProviderEnrollment@michigan.gov or providersupport@michigan.gov.
Claim Submission
You may submit your claims one of three ways:
- Clearinghouse: Payor ID BBMDQ
- NOTE: Payor ID for Blue Cross Blue Shield of Michigan (BCBSM) Commercial, Medicare Advantage and BCBSM Healthy Kids Dental
- Provider portal for electronic claims submission and eligibility verification for members Blue Cross Blue Shield of Michigan (BCBSM) Commercial, Medicare Advantage, and BCBSM Healthy Kids Dental members:
- Paper Claims can be mailed to:
- For BCBSM Commercial and Medicare Advantage claims:
BCBSM
PO Box 49
Detroit, MI 48231
- For BCBSM Healthy Kids claims
Blue Cross Blue Shield of Michigan
Attn: Claims
PO Box 491
Milwaukee WI 53201-0491
Provider Resources:
Contact Information:
- DentaQuest Customer Service: 844-870-3977
- DentaQuest Credentialing Help Desk: 800-233-1468
- DentaQuest Provider Services:
- BCBSM Medicare Advantage and Healthy Kids: 844-876-7917
- BCBSM Commercial Plans: 888-826-8152