Rank: New Member
Joined: 12/13/2012(UTC)
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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
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Rank: Administration
Joined: 11/21/2012(UTC)
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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)
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