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Dental Claim Form
HEADER Information
1. Type of Transaction (Mark all applicable boxes)
Statement of Actual ServicesRequest for Predetermination/PreauthorizationEPSDT / Title Policyholder/SUBSCRIBER
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How to fill out bcbsnc dental blue select
How to fill out bcbsnc dental blue select
01
To fill out the BCBSNC Dental Blue Select form, follow these steps:
02
Start by gathering all the necessary information, including your personal details and dental coverage details.
03
Double-check if you are eligible for BCBSNC Dental Blue Select and if you meet all the requirements.
04
Read the form carefully and understand the questions before filling them out.
05
Provide accurate and complete information in each section of the form. Make sure to include all the required details such as your name, address, contact information, and dental provider information.
06
If you have any specific dental needs or preferences, mention them clearly in the appropriate sections.
07
Review the completed form to ensure that all the information provided is correct and legible.
08
Sign and date the form as required.
09
Submit the filled-out form through the specified method, such as mailing it to the designated address or submitting it online.
10
Keep a copy of the filled-out form for your records.
11
Note: It is always recommended to review the form instructions or consult with BCBSNC customer service if you have any doubts or questions during the filling out process.
Who needs bcbsnc dental blue select?
01
BCBSNC Dental Blue Select is beneficial for individuals or families who:
02
- Require dental coverage and want access to a network of preferred dentists and specialists
03
- Prefer a dental plan that offers extensive coverage for preventive services, oral exams, cleanings, and X-rays
04
- Are looking for an affordable dental plan with cost-sharing options
05
- Want the flexibility to choose their own dentist from the extensive network provided by BCBSNC
06
- Value coverage for major dental services such as root canals, extractions, and crowns
07
- Are interested in additional benefits such as orthodontic coverage for children (under the age of 19)
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What is bcbsnc dental blue select?
bcbsnc dental blue select is a dental insurance plan offered by Blue Cross Blue Shield of North Carolina.
Who is required to file bcbsnc dental blue select?
Employers who provide dental insurance coverage through bcbsnc dental blue select are required to file.
How to fill out bcbsnc dental blue select?
You can fill out bcbsnc dental blue select by submitting the necessary forms and information to Blue Cross Blue Shield of North Carolina.
What is the purpose of bcbsnc dental blue select?
The purpose of bcbsnc dental blue select is to provide dental insurance coverage to individuals and families.
What information must be reported on bcbsnc dental blue select?
Information such as employee enrollment, premiums paid, and dental services covered must be reported on bcbsnc dental blue select.
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