Blue Cross Of CaliforniaCommercial Clinical Policy

PathWays Dental Benefits Flier - English Form

Chat with GenHealth to automate any policy or prior auth task.


PathWays Dental Benefits Flier - English

Indications

(1) Does the request meet this criterion: Two oral exams and one cleaning.? 
(2) Does the request meet this criterion: One set of bitewing X-rays and one complete set of X-rays every three years.? 
(3) Does the request meet this criterion: Medically necessary treatment.? 
(4) Does the request meet this criterion: Emergency treatment.? 
(5) Does the request meet this criterion: Comprehensive oral exam limited to one per lifetime, per member, per provider.? 

YesNoN/A
YesNoN/A

Sign up to see the rest of the questions

Unlock the remaining questions and the full coverage workflow.

Sign up for free
Effective Date

NA

Last Reviewed

NA

Original Document

  Reference



Each year, PathWays members can access: • Two oral exams and one cleaning. • One set of bitewing X-rays and one complete set of X-rays every three years. • Medically necessary treatment. • Emergency treatment. • Comprehensive oral exam limited to one per lifetime, per member, per provider. • A periodic or limited oral exam is limited to one every six months, per member. Note: Topical fluoride is not covered. RR 2023 1058792INMENABS 06/23 01/11/2024 Serving Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging Dental care to keep you smiling A bright, healthy smile is a sign of good dental health. And that makes a difference for your overall health, especially as we age. Dental care for older adults can include concerns that younger adults don’t have. That’s why it’s important for Indiana PathWays for Aging members to stay on track with their dental benefits through DentaQuest. Getting dental care is easy. Just call DentaQuest at 888-291-3762 (TTY 800-466-7566) to get on the road to better dental health and a lot of smiles. anthem.com/inmedicaid

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Do you need help with your healthcare, talking with us, or reading what we send you? We provide our materials in other languages and formats at no cost to you. Call us toll free at 866-408-6131 (Hoosier Healthwise, Healthy Indiana Plan); 844-284-1797 (Hoosier Care Connect); 833-412-4405 (Indiana PathWays for Aging); TTY 711. ¿Necesita ayuda con su cuidado de la salud, para hablar con nosotros o leer lo que le enviamos? Proporcionamos nuestros materiales en otros idiomas y formatos sin costo alguno para usted. Llámenos a la línea gratuita al 866-408-6131 (Hoosier Healthwise, Healthy Indiana Plan); 844-284-1797 (Hoosier Care Connect); 833-412-4405 (Indiana PathWays for Aging); TTY 711.

Book a walkthrough

Walk through this policy with us

Review how this policy can be converted into cited criteria, prior authorization checks, and operational automation.