Blue Cross Blue Shield of MI Dentist Page

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Important Information about BlueCross BlueShield of Michigan

As of Nov 1, 2019, both Blue Cross Blue Shield of Michigan and Blue Care Network commercial dental programs transitioned to DentaQuest for claim processing and other administrative duties.

Claims: DentaQuest will process your BCBSM Commercial claims. You must update your clearinghouse electronic Payor ID to BBMDQ, mailing addresses, and links for online submission to ensure that the claims are being accurately submitted.

There will be no changes to network affiliations or member benefits as a result of this transition.

To support this important partnership, DentaQuest has launched a provider portal system for Blue Cross and BCN commercial, Medicare Advantage, and Healthy Kids Plan providers. Providers not yet registered on the portal should have received a letter from DentaQuest regarding how to register. The letter contained the BUSINESS KEY which is vital for registration. If you did not receive this letter and need a business key, please call provider services or your provider engagement representative.
Please follow the helpful links below for portal registration, guidance and training information.

Click here to register and login for the BCBSM Provider Portal
Click here for information regarding BCBSM Portal Training and Orientation
Click here for the BCBSM Provider Summary Guide


Blue Cross Blue Shield of Michigan Commercial Dental Plans Payment Information

Attention BCBSM and BCN Commercial Providers: If you wish to receive electronic BCBSM payments you must contact DentaQuest. Information and forms to sign up for EFT are available here: http://dentaquest.com/state-plans/regions/michigan/dentist-page/eft-direct-deposit/, you may also sign up directly through the provider portal at provideraccess.dentaquest.com

Attention BCBSM Healthy Kids Dental Providers

Verification of eligibility on the date of service of each BCBSM HKD member is essential as eligibility for these members may change frequently. If you do not check eligibility on the date of service for a BCBSM HKD member before you begin treatment, and deliver services to an ineligible member, you cannot receive reimbursement from BCBSM and cannot bill the member for the services. If you have not already done so, please set up a process where you check BCBSM HKD member eligibility on their appointment days. To check eligibility via the BCBSM provider portal, visit provideraccess.dentaquest.com

Please refer to the BCBSM Healthy Kids Dental Office Reference Manual for covered benefits and important information about this plan.

MI BCBSM Healthy Kids Dental Office Reference Manual update

The BCBSM Healthy Kids Dental Office Reference Manual has been updated, effective 9/27/2021. Please visit the "provider resources" section to review the new ORM in detail.  

 

CHAMPS notice:

All BCBSM Healthy Kids Dental providers who serve BCBSM Healthy Kids dental beneficiaries are required to enroll in CHAMPS in order to receive payment from the Dental Health Plan.

For dates of service on or after January 1, 2019, MDHHS will prohibit contracted Medicaid Health Plans and Dental Health Plans from making payments to providers not actively enrolled in CHAMPS. Please take immediate action to enroll in CHAMPS or renew your enrollment if it has expired. You must revalidate your information with CHAMPS every 5 years.

To enroll in CHAMPS: To review instructions on this process:
  • Visit www.michigan.gov/mdhhs
  • Select “Providers” from the left side menu, then the “Providers” link
  • Click “CHAMPS” logo
  • Scroll down to “Accessing the CHAMPS System” to find the “SSO Instructions” link

 
If you have any questions or need assistance with enrollment, please contact the Medicaid Provider Help Line 1.800.292.2550 or email ProviderEnrollment@michigan.gov or providersupport@michigan.gov.
 

Claim Submission

You may submit your claims one of three ways:
  • Clearinghouse: Payor ID BBMDQ
    • NOTE: Payor ID for Blue Cross Blue Shield of Michigan (BCBSM) Commercial, Medicare Advantage and BCBSM Healthy Kids Dental
  • Provider portal for electronic claims submission and eligibility verification for members Blue Cross Blue Shield of Michigan (BCBSM) Commercial, Medicare Advantage, and BCBSM Healthy Kids Dental members:
  • Paper Claims can be mailed to:
    • For BCBSM Commercial and Medicare Advantage claims:
      BCBSM
      PO Box 49
      Detroit, MI 48231
    • For BCBSM Healthy Kids claims
      Blue Cross Blue Shield of Michigan
      Attn: Claims
      PO Box 491
      Milwaukee WI 53201-0491

Provider Resources:

 

Contact Information:

DentaQuest Customer Service: 844-870-3977
DentaQuest Credentialing Help Desk: 800-233-1468
DentaQuest Provider Services:
 BCBSM Medicare Advantage and Healthy Kids: 
844-876-7917
 BCBSM Commercial Plans: 888-826-8152