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DPAP 400

FEP Policy Identifiers for Benefits and Fee Schedules


Provider Administrative Policy

Section
FEP
Policy Date
December 2013
Status/Date
Revised/October 2014
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Blue Cross of Idaho works diligently on behalf of our members to develop contracting relationships with Idaho dental providers and Blue Cross Blue Shield dental affiliates (national Dental Grid).

 


Policy

FEP Policy Identifiers for Benefits and Fee Schedules

Members of the Federal Employee Program (FEP) may choose between two dental policies, Basic Option and Standard Option. Please view the member's identification card to determine his/her policy. The fee schedule varies depending on the option selected.

The Basic Option is identified by the following on the identification card:

  • Enrollment Code 111 (self only coverage) or 112 (family coverage)
  • Basic displays on the front upper right side of the card

 The Standard Option is identified by the following on the identification card:

  • Enrollment Code 104 (self only coverage) or 105 (family coverage)
  • PPO displays on the front upper right side of the card

FEP Identification Card Sample

When Blue Cross of Idaho receives a dental claim on FEP member's medical policy for dates of service on or after May 1, 2014, we will process it based on the member's FEP medical plan benefits and the provider's contracting status as follows:

  • Preferred Network for FEP - Preferred Provider Organization (PPO)
  • Participating Network for FEP - Traditional
  • Out of Network of FEP - Non-contracting Providers

Members of FEP may elect to purchase a voluntary dental plan, FEP BlueDental. The Blue Cross Blue Shield Association (BCBSA) partnered with the GRID Dental Corporation (GDC) to administer FEP BlueDental. Please verify your patient's insurance at the time of visit, and note the following guidelines before submitting a claim:

  • By law, an FEP member's medical policy is primary to the FEP member's elective supplemental policy, FEP BlueDental. Ask for the member's medical ID card to get the primary carrier's information. You may submit claims to the address indicated on the back of their insurance card.
  • When Blue Cross of Idaho receives a claim for processing on a FEP member's medical policy, we will transmit the claim on your behalf through the member's secondary FEP BlueDental policy if you indicate the secondary policy information on the claim.
  • Contracting providers with Blue Cross of Idaho's Traditional network are in-network providers for the GRID+ network for these dental plans.

Follow the below steps to view the FEP dental fee schedules based on type of policy:

  1. Access www.fepblue.org
  2. Select Benefits + Services  from the top navigation bar
  3. Select Standard Option or Basic Option from the left navigation bar
  4. Select Dental to view the fee schedule for the option selected

Policy History

Date Action Reason
October 2014 Revised Updated to include FEP BlueDental