Changes to Clinical Policy and Benefits

Over the past several months, we have been working to streamline our processes and policies in order to better serve you and our members. Please take the time to read the red-lined version of the Blue Cross Dental clinical policies and benefit changes that will become effective with dates of service September 1, 2016, and later.

Some of the revisions you’ll see include a change back to a calendar year schedule for calculating the frequency of preventive procedures, including bitewing x-rays that will now be covered once per calendar year (changed from once per 18 months).

You will also see changes to policies related to the following services:

  • Amalgams and composites
  • Denture adjustments
  • Crown and bridge repair
  • Prophylaxis / scaling and root planing
  • Post removal
  • Post and core

Please note: Some of the changes red-lined in the documents are intended to clarify the existing policy and corresponding member or provider liability, but do not change our existing guidelines.

Additionally, as in the past, some large group employers choose benefits outside of Blue Cross Dental clinical policy. These are group-specific benefits and are reflected on the web in My Patients Benefits or in the member’s subscriber agreement.

Please verify the detailed level benefits at the time of service to ensure you have the most accurate benefit information.

Read policy changes