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New Network Provider and Bigger Network
for BlueCare Dental PPO
Effective April 1, DenteMax will become
the new BlueCare Dental PPO national provider network.
This network increases the number of contracting
providers to more than 46,000 dentists in 48 states,
plus the District of Columbia – adding approximately
12,000 providers to the current network.
Established in 1985 as a subsidiary of Blue Cross
and Blue Shield of Michigan, DenteMax now serves
nearly three million members. Clients include the
Blue Cross Plans of Michigan, Wisconsin, New Jersey
and New York (Rochester, Syracuse and Utica-Watertown),
as well as third-party administrators and Taft-Hartley
funds.
Like a medical PPO, BlueCare Dental PPO decreases
dental health care costs by using contracting providers
who agree to accept discounted fees. The standard
plan designs reimburse dentists at the same discounted
rate – whether in or out of network. Your
clients can expect even greater savings with the
new network. Along with the deep provider discounts
already available in Illinois, Texas and New Mexico,
this network offers an average discount of 25 percent
across all 48 states. While the actual discount
level varies geographically, key states such as
California, New York, Florida and Georgia offer
some of the deepest discounts.
Standard Dental PPO plan designs are not affected
by this change. Employer groups with 151+ employees
still have the option to select a plan design that
pays “usual and customary” (U &
C) out-of-network or a “passive” plan
design that pays the same benefit level both in
network and out-of-network, with out-of-network
claims paid at the U & C. However, in either
plan design, employer groups and members realize
a greater savings only when in-network providers
are used.
Replacement ID cards showing the new dental network
will be issued to existing BlueCare Dental PPO members
for the April 1 effective date. Also, the Dental
Provider Finder® on the Blue Cross Web site
will also be updated with new network information.
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