Dental Office Resources

 

Forms

 

Claim Form

Download a claim form to submit claims and preauthorizations.

 

W-9

Complete this form when a tax identification number or business name has changed, or this form is one document to complete for a provider new to Blue Cross of Idaho.

 

Dentist Profile Form

Complete this form when adding a provider to your practice or when setting up a new practice.

 

NPI Form

Use this form to submit organizational NPI number and/or individual NPI number(s) to Blue Cross of Idaho Dental Services.

 

Provider Change Notice

Use this form to notify Blue Cross of Idaho of a change to your tax identification number or a change of address o- click here to access a form to notify us when a dental provider no longer works at your location.

 

Provider Contracting

 

To request a PPO or Traditional contract or for questions pertaining to contracting, please contact Dental Services at 208-363-8755 or 1-800-289-7929.

 

Informational Flyers

 

Blue Cross of Idaho Contracting Affiliates

Refer to this list of Blue Cross of Idaho dental affiliates to find out which insurance companies belong to the Blue Cross of Idaho network.

 

 

 

 

 

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