Although it is not required, PEBA suggests that you obtain a pretreatment estimate of your non-emergency treatment for major dental procedures. To do this, you and your dentist should fill out a claim form before any work is done. The completed form should list the services to be performed and the charge for each one. Mail the claim form to:

BlueCross BlueShield of South Carolina
Basic Dental Claims Department
P.O. Box 100300
Columbia, SC 29202-3300

You and your dentist will receive a pretreatment estimate, showing an estimate of the expenses your dental plan will cover. This form can be used to file for payment as the work is completed. Just fill in the date(s) of service, ask your dentist to sign the form and submit it to BlueCross. Your pretreatment estimate is valid for 90 days from the date of the form. The actual date of service may affect the payment allowed. For example, if you have reached your maximum yearly payment when you have the service performed or if you no longer have dental coverage, you will not receive the amount that was approved on the pretreatment estimate. Emergency treatment does not need a pretreatment estimate.

If Basic Dental is your secondary insurance, the pretreatment estimate will not reflect the estimated coordinated payment, because BlueCross will not know what your primary insurance will pay.

To determine the allowed amount for a procedure, ask your dentist for the procedure code. Then call BlueCross’ Dental Customer Service at 888.214.6230 or 803.264.7323.