2025 Medicare Advantage Dental reimbursement rates

Please note that claims with dates of service on or after January 1, 2025, will be reimbursed based on the rates in the 2025 fee schedule. Learn more

Online services

Availity Essentials

View benefits, claims-related information, reimbursement schedules, and more. All contracted providers are required to register with Availity Essentials, submit claims electronically, and receive claims payments via electronic funds transfer (EFT).

Availity Essentials should be used to obtain eligibility, benefits, and real-time authorization for members of the BlueCross BlueShield Federal Employee Health Benefits Standard and Basic option plans.

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MyDentalCoverage

Regence dental members began transitioning to our new service platform on September 1, 2023. The transition will continue in a phased manner through 2024. You will be able to use both Availity and MyDentalCoverage through 2024 for patients who have transitioned to the new service platform, but we encourage you to use MyDentalCoverage. An alert will display in Availity for patients who are on the new platform.

Providers can use the MyDentalCoverage portal to: 

  • Register for electronic funds transfer (EFT) 
  • View remits directly 
  • Submit or review claims status
  • Verify your patients’ dental benefits and eligibility 
  • Submit pre-treatment estimates
  • Chat online with a dental customer service representative

 

FAQs

Perform an eligibility and benefit inquiry on Availity Essentials. If the member has transitioned, the response you receive will include a message stating that the member is on the new MyDentalCoverage platform.

The patient cost estimator is no longer available on Availity for dental business, for cost estimations for non-transitioned members please file a pre-determination on Availity Essentials.  All other members submit pre-determinations on MyDentalCoverage or use the online cost estimator. 

Benefits will be predetermined under the assumption that Regence is the primary insurer. If the patient is insured under more than one policy, actual benefits payable may be adjusted due to coordination of benefits (COB) or maintenance (non-duplication) of benefits (MOB).

Predeterminations are provided as a courtesy and are not a guarantee of payment. All services are subject to the benefits, eligibility and maximum allowable amounts in effect on the actual date of service. Estimated payment may be reduced due to prior payments for treatment. Actual benefits payable will depend upon the following:

  • Benefits available
  • Member contract limitations
  • Provider participating status
  • Patient and provider eligibility
  • Benefit maximums in effect when the services are completed

The cost estimator is no longer available in Availity. To receive estimated costs you will need to submit a pre-determination through the Availity portal. For a member who has transitioned to the new platform, please visit MyDentalCoverage.com.