What`s New!
State of Idaho Selects Blue Cross of Idaho to Administer Dental Benefits
Beginning July 1, 2009 Blue Cross of Idaho will administer the dental benefits for State of Idaho employees. The benefits and covered services currently available to state employees will remain the same. Highlights of this coverage include:
$1,000 benefit period maximum (July 1 – June 30)
$25 deductible per enrollee*
$1,000 orthodontia lifetime benefit for dependent children under age 19
Subject to credit for prior orthodontia benefits paid. Orthodontia treatment must begin prior to age 17.
- Oral exams covered once every six months
- Cleanings (regular or periodontal maintenance) covered once every six months
- Fluoride treatment covered once every 12 months for dependent children under age 20
- Sealants covered on permanent posterior unrestored dentition once every three years for children under age 16
- Same tooth-surface restoration covered once in 24 months
- Seven-year replacement for prosthodontics
- Implant lifetime benefit of $900 per tooth (includes crown) and applies to benefit period maximum
- Predeterminations encouraged for all prosthodontics
Both PPO and Traditional providers are considered in-network
| PPO | Traditional | Out-of-Network | |
| Preventive & Diagnostic Services Includes periodontal maintenance and full mouth debridement |
80%* | 70% | 70% |
| Fillings and Sealants | 80% | 70% | 70% |
| Oral Surgery & Anesthesia | 80% | 50% | 50% |
| Endodontics | 80% | 50% | 50% |
| Periodontics | 80% | 50% | 50% |
| Prosthodontics | 50% | 50% | 50% |
| Implants | 50% | 50% | 50% |
| Orthodontia | 50% | 50% | 50% |
| *deductible does not apply | (percentage of applicable maximum allowance) | ||
There is a 12-month waiting period for orthodontia and prosthodontics for new enrollees. Blue Cross of Idaho will credit waiting periods for existing enrollees.
Be sure and obtain a copy of your patients’ new Blue Cross of Idaho identification card on their next visit. To expedite claims processing, consider submitting your claims electronically. For more information, please phone our EDI Help Desk at (208) 331-8817 or (888) 224-3341.
Blue Cross of Idaho is pleased to announce our partnership with National Electronic Attachment (NEA). You can now send electronic attachments with dental claims to Blue Cross of Idaho via National Electronic Attachment"s (NEA) FastAttachSM system. This system is Internet-based and allows dental offices to transmit X-rays, narratives, explanation of benefits, and other claim documentation at a low cost.
FastAttachSM is easy to use, inexpensive, eliminates lost documentation, decreases postage expense, and can be used with all windows-based practice management systems. Your images are stored in NEA"s secure repository.
You may submit electronic attachments to Blue Cross of Idaho only with electronic claims. If you currently do not submit claims electronically and wish to do so, please contact your practice management software company, or Blue Cross of Idaho"s electronic data interchange (EDI) claims clearinghouse at (888) 224-3341, option 3 to learn how to further-reduce your expenses and expedite payment of your dental claims.
NEA is offering FREE registration to new dental providers who sign up before February 28, 2009. Registration includes software, installation, training, and unlimited telephone support for your office. For more detailed information on this system, please contact NEA directly at www.nea-fast.com or (800) 782-5150, option 2. To take advantage of this special offer now, visit the NEA Web site at www.nea-fast.com and enter the promotion code BCIDZ.
If you are already participating with NEA, you may begin submitting your attachments electronically to Blue Cross of Idaho now!
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