Blue Cross Blue Shield FEP Dental
Section 3 How You Obtain Care
Section 3 How You Obtain Care
Dental Review
BCBS FEP Dental’s claim review is conducted by licensed dental professionals who review the clinical documentation submitted by your treating dentist.
These licensed dental professionals will review necessary clinical notes and diagnostic images checking for dental necessity for procedures including but not limited to onlays, crowns, build ups, bridges, implants , periodontal treatment, extractions and anesthesia. The licensed dental professionals may extend an alternate benefit equivalent to that of another professionally acceptable form of treatment in accordance with the terms of the BCBS FEP Dental Plan.
The member has the right to appeal any unfavorable clinical decision provided that new additional supporting documentation has been received. The member’s dental provider can appeal on the member’s behalf.
These licensed dental professionals will review necessary clinical notes and diagnostic images checking for dental necessity for procedures including but not limited to onlays, crowns, build ups, bridges, implants , periodontal treatment, extractions and anesthesia. The licensed dental professionals may extend an alternate benefit equivalent to that of another professionally acceptable form of treatment in accordance with the terms of the BCBS FEP Dental Plan.
The member has the right to appeal any unfavorable clinical decision provided that new additional supporting documentation has been received. The member’s dental provider can appeal on the member’s behalf.