Dental Supplement

Procedures for Requesting Preauthorization continued:
Once a decision has been reached on the requested dental treatment, the dental
office will receive written notification. Treatment should not begin until the dental
office has received the decision in writing from PBC and the patient’s eligibility is
confirmed. If treatment is provided prior to approval or if the patient’s coverage
has cancelled, payment will be denied.
Approvals are valid for one year from date of approval and only if eligibility
requirements have been met at the time the services are provided. The dentist
who received approval must provide the treatment. If circumstances change and
the approved treatment is to be completed by another dentist, Pacific Blue Cross
must be contacted to amend the approval before treatment is started.
Payment Process:
When the approved treatment has been completed, claims must be submitted on a
standard dental claim form to:
Pacific Blue Cross
P.O. Box 65339
Vancouver, BC
V5N 5P3
Treatment that is approved under the Ministry Crown and Bridgework Supplement
will be paid in excess of the patient’s basic dental limit and in accordance with the
rates outlined in the Schedule of Fee Allowances – Crown and Bridgework and,
where applicable, are inclusive of lab fees. No lab slips are required. These fees
represent the maximum amount the Ministry can pay for the services billed.
All other dental treatment must be completed either within the patient’s basic
dental limit or in accordance with the Emergency Dental and Denture
Supplements.
April 1, 2010
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