DentalWriter Forum

Your central resource for DentalWriter posts, blogs, training resources, faq's, and more.

Notification

Icon
Error

New Topic Post Reply
mschmitt
#1 Posted : Thursday, December 13, 2012 12:55:27 PM(UTC)
Quote
mschmitt

Rank: New Member

Joined: 12/13/2012(UTC)
Posts: 1

Our office recently contacted bc/bs to ask a general question regarding one of our employees whom is going to have implant work done and we were going to submit under her medical. When i contacted bc/bs they said that only oral surgeons are accepted as being able to cross code under medical. General dentists are not recognized. Please advise do i press paperwork or since i was told from 2 supervisors dont bother where do i go or do from here?
margie
courtneydsnow
#2 Posted : Tuesday, December 18, 2012 1:29:33 PM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,611

Thanks: 39 times
Was thanked: 51 time(s) in 51 post(s)
Hi Margie!

It is true that there are still some insurers out there that will not allow a dentist to be a contracted in-network provider on the medical side....but there is no rule against a dentist submitting a medical claim to a medical insurer using medical codes! I do have personal experience in dental offices being reimbursed by bc/bs for oral appliances for sleep apnea.

Two questions for you....

1) Is this an HMO policy? (or EPO?)

2) If it is not an HMO, but a PPO plan: were you by chance asking for a GAP exception to be considered as an in-network provider? (so the patient can utilize their in-network benefits instead of out of network benefits)

Quick Reply Show Quick Reply
New Topic Post Reply
Forum Jump  
You can post new topics in this forum.
You can reply to topics in this forum.
You can delete your posts in this forum.
You can edit your posts in this forum.
You cannot create polls in this forum.
You can vote in polls in this forum.