Blue Cross Blue Shield FEP Dental
Section 3 How You Obtain Care
Section 3 How You Obtain Care
Precertification
Precertification, also known as pre-treatment estimate, is not mandatory. Although pre-treatment estimates are not required BCBS FEP Dental strongly recommends and highly encourages pre-treatment estimates be submitted for all major and extensive services prior to treatment. Major Services are subject to licensed professional review. Such review may include but not be limited to the following services: extensive oral surgery, periodontal, major restorative, (crowns, bridges, inlays/onlays), endodontic, prosthodontic, implants and related treatments, and orthodontics. Extensive and clinically involved treatment plans will require additional supporting documentation such as chart notes, x-rays also known as radiographic images, photos, and may alternate to a least costly professionally acceptable procedure.
We will provide a non-binding, explanation of benefits to both you and your dentist that will indicate if procedures are covered and an estimate of what we will pay for those specific services. The estimated Maximum Allowable Amount is based on your current eligibility and contract benefits in effect at the time of the completed service. Submission of other claims or changes in eligibility or the contract may alter final payment. A pretreatment estimate is not a guarantee of benefits.
The final determination of eligibility is determined when the claim process. Please note that you are not required to submit pretreatment estimates to your FEHB carrier. They may be submitted directly to BCBS FEP Dental at:
BCBS FEP Dental
P.O. Box 75
Minneapolis, MN 55440-0075
We will provide a non-binding, explanation of benefits to both you and your dentist that will indicate if procedures are covered and an estimate of what we will pay for those specific services. The estimated Maximum Allowable Amount is based on your current eligibility and contract benefits in effect at the time of the completed service. Submission of other claims or changes in eligibility or the contract may alter final payment. A pretreatment estimate is not a guarantee of benefits.
The final determination of eligibility is determined when the claim process. Please note that you are not required to submit pretreatment estimates to your FEHB carrier. They may be submitted directly to BCBS FEP Dental at:
BCBS FEP Dental
P.O. Box 75
Minneapolis, MN 55440-0075