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stratforddental
#1 Posted : Wednesday, February 26, 2014 4:12:31 PM(UTC)
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stratforddental

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Can a dentist have consideration to be an in-network provider with medical? If yes, it he medical and dental plan are the same does the medical payment carry over to dental? Can you bill both if they are the same in other words if one does not pay?
courtneydsnow
#2 Posted : Wednesday, February 26, 2014 5:55:37 PM(UTC)
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courtneydsnow

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Hi stratforddental!

The short answer to this one is yes, a dentist can be considered an in-network provider or supplier with medical insurance.

The long answer is - some insurers will only contract with oral surgeons & physicians! But, i work with many dental offices who have obtained in-network medical contracts across the country. For example, for medicare for sleep apnea appliances, the dentist must contract with Medicare DME as a DME supplier, instead of a medicare provider like a physician would.

Really what this comes down to.....is it depends on the payer. Contact them ask their provider relations/credentialing department how best to apply to be an in-network provider and/or supplier.

The medical and dental plan are not the same, and will not pay the same. You are looking at a different deductible, and coinsurance, basically a whole different benefit breakdown.

If you bill both medical & dental for something, you will want to submit the claim to medical first, then to dental when you get the EOB back from the medical plan (you will need to submit a copy of the EOB from the medical policy with your dental claim, or visa versa, but normally you will want to file medical before you do dental if you're filing both).

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archdental
#14 Posted : Friday, April 24, 2015 10:30:16 AM(UTC)
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archdental

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As we are out of network, when billing anthem, I am told I have to bill BCBS of IN since its the state where services are rendered regardless of what BCBS state they have, is this true? What is the correct Anthem BCBS of IN claims address? I've also heard of some BLUEcard thing when trying to call about claims or send in, that its through them when its an out of state Anthem, how does this work? Is there a direct number to call Anthem BCBS if IN to talk to someone about claims if I ever need to? Please help solve this confusion.

Trystan
courtneydsnow
#15 Posted : Saturday, April 25, 2015 8:23:57 AM(UTC)
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Hi Trystan!

Great questions. Yes some BCBS branches will have you file with the local if billing an out of state plan, that is definitely not uncommon!

The claim mailing address for Anthem BCBS of Indiana as listed on their website is:

Anthem Blue Cross and Blue Shield of Indiana
P.O Box 105557
Atlanta, GA 30348-5557

And the contact phone number is listed as: 1-800-382-5520

Here is a link to their contact us page: http://www.anthem.com/wps/portal/ahpfep?content_path=fep/noapplication/f6/s1/t0/pw_a129791.htm&label=Contact+Us

As far as the Blue Card Program, here is a link that explains what it is, how to identify a bluecard member, claim mailing address, and contact information:

http://www.anthem.com/wp...d%20Program&state=oh

Hope this helps, please let us know if you have any further questions!
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