Blue Cross and Blue Shield of Illinois (BCBSIL) is updating some of its processes as part of our commitment to providing you ease in doing business with us.

Currently, Dental Network of America (DNoA) handles all aspects of the dental HMO (DHMO) product, including billing, membership maintenance, claims, customer service, producer commissions, provider network and capitation. To create efficiencies and enhance customer service to producers, employer groups and members, we are in a transition process to bring certain administrative functions for the DHMO product in sync with our other health and dental products and all systems and portal functionality and capabilities. The transition is scheduled to be completed in January 2009.

Advantages for You and Your Customers
Overall, this project will provide the following advantages for all dental products (HMO, PPO, Traditional).

• Combines producer commissions: You will now receive commissions for all your BCBSIL business through Producer Administration, rather than receiving your DHMO portion on a separate check from DNoA. 

• Standardizes billing: DHMO groups that have other benefit programs through BCBSIL will begin receiving bills in the format they are accustomed to for their other products. For DHMO-only customers, the first BCBSIL statement should be a “superbill,” which explains how to read their new statement.

• Allows employers to manage their account online: DHMO customers will now be able to manage this benefit program through Blue Access® for Employers. They will be able to add and terminate members online at their convenience, without submitting any paperwork. Employers will also be able to pay their bill online.

• Gives members online access to their DHMO claims: Through Blue Access® for Members (BAM), DHMO members will now be able to view their Explanation of Benefits (EOB).

• Enhances administrative functions: This systems integration enhances electronic communication, helping to decrease the new business set-up cycle time for DHMO accounts, more quickly recognize benefit changes for existing business and update capitation/eligibility accordingly.

• Uninterrupted customer service and provider relationships: This project will provide DNoA access to all information as before, allowing them to continue to provide excellent customer service to our DHMO members, handle claims and all provider-related activities (networking, inquiries, issues, etc.) for a seamless transition.

New Payment Requirements
As part of this transition, there will be some billing changes. Beginning with the January 2009 statement, the DHMO bill will come directly from BCBSIL rather than from DNoA. The following changes regarding payment process will occur:

• Payment by check: There will be a new address to remit payment – Blue Cross and Blue Shield of Illinois, P.O. Box 1186, Chicago IL 60690-1186.

• Payment by wire transfer: The group will need to complete an authorization form to initiate this ongoing transaction method.

• New Feature: Online payment: Groups will now be able to pay online through Blue Access for Employers (BAE). Groups that already are registered for online bill payment through BAE can simply update their account to add a billing profile for DHMO to begin paying online. Current DHMO-only customers will need to first set up a BAE account and then create a payment profile to begin paying online. Groups are expected to be able to create a payment profile for DHMO beginning in early December 2008. Should your clients need assistance setting up a billing or payment profile, instructions can be found in the Online Payment Help section within BAE.

Important: To help simplify this transition, all existing DHMO customers are being set up with a separate billing profile for DHMO as part of the conversion process. Upon renewal, if the account desires, the billing profiles can then be combined into one bill.

The billing schedule will change as well. The November DHMO bill is mailing around October 25, 2008, to coincide with the BCBSIL billing schedule. The first statement from BCBSIL, for January, will be mailed around December 22.

Revised Producer Commission Schedule Effective 1/1/09
Along with this process change, we are announcing a revision to the Illinois Sales Group Producer Commission Agreement Schedule, effective January 1, 2009, for all new sales and existing accounts. The DHMO commission will be the same as our medical and dental PPO commissions. The new Illinois Sales commission schedule is now posted within Blue Access® for Producers.

Groups to Be Notified Shortly
We are communicating these changes with employers and providing updates via the Benefits Management Briefing newsletter and BAE, a separate mailing sent directly to group benefits administrators and an insert included in the November DHMO bill. An announcement will also be posted in BAM, letting DHMO members know they will be able to view their dental claims online. Continue to check Blue Access® for Producers and watch the In the Know electronic newsletter for updates on this important project.