Blue Cross Blue Shield Dental Insurance in Katy

Which Blue Cross plan you have

There is no single national Blue Cross Blue Shield dental policy. Each Blues company — Blue Cross Blue Shield of Texas is the one many Katy patients carry — writes its own dental benefits or partners with a dental network. The suitcase logo on a medical card does not, by itself, tell us your cleaning frequency or your crown benefit.

Dentality Family Dentistry accepts Blue Cross Blue Shield dental plans and files the claim. When you call or book, we ask which Blues plan and whether you have a separate dental card. FEP (federal employee) Blue Cross dental, a state employee plan, and a private employer PPO can all say Blue Cross and still pay differently.

Katy patients most often carry Blue Cross Blue Shield of Texas, but we also see federal employee Blue Cross and plans written in other states. The prefix on the card tells us which company to bill, and we do that lookup before the appointment when you send the card ahead.

How benefits are usually organized

Blues dental PPOs follow the familiar three buckets. Preventive care is exams, cleanings, and routine X-rays. Basic care includes fillings and many extractions. Major care includes crowns, bridges, and dentures. Your group sets the coinsurance and the annual maximum. Some cards also show a separate orthodontic lifetime maximum, which does not refill every January.

We verify those numbers, plus whether you have already had a cleaning in the current benefit year. Benefit years are not always the calendar year. A plan that renews on your hire date will not reset on January 1, and we do not want to schedule a second cleaning the plan will not pay.

A Blue Cross medical deductible does not pay your dental deductible, and using medical benefits at a hospital does not use up the dental maximum. We keep those two accounts separate so a medical year does not get mistaken for a dental year.

What to bring

If your card has both a medical side and a dental rider, photograph the side that lists dental claims. The three-letter prefix is small and easy to crop out, and that prefix is what routes the claim.

• The dental ID card, even if you also have a Blue Cross medical card
• The three-letter prefix or plan code printed on the card
• Subscriber date of birth if the policy is not in your name
• Any explanation of benefits from dental work done this benefit year

Billing

We submit the claim to the Blues dental payer on the card. If that payer asks for films, we send them from our records. You receive the explanation of benefits at the address or portal on your account.

A balance after insurance can be paid here or reviewed for financing. See every accepted plan on the insurance and financing page.

Blue Cross explanations of benefits sometimes show an alternate benefit, which means they paid for a less expensive version of the procedure. We will point that line out if it is why your share is higher than the first estimate.