by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Dec 9th, 2019
This information can be found on Regence/Blue Cross Dental procedures explaining additional benefits for dental procedures. Regence currently does not offer dental benefits, however, there are times a patient can receive treatment with a Blue Cross provider and qualify under their medical benefits. In addition, Regence informs the providers to file these claims electronically in the same format used for medical claims. Most other payers offer the same access to treatment. Remember to always verify benefits and coverage prior to any treatment.
"Dental services are excluded from the BlueCard Program.
However, there are times when a procedure performed in a dental office qualifies for payment under the patient's medical plan.
Some common medical billing scenarios include:
- Traumatic injuries
- Sleep apnea appliances
- Biopsies of suspicious lesions
- Temporomandibular joint dysfunction (TMD) orthotics
- Extraction of third molars (not a medical benefit for all Blue Plans)"
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
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