AdministrativeDentalAugust 1, 2024

Dental Net and SelectHMO Participating Providers: Member Encounter Data

This communication applies to dentists only.

As a part of the Dental HMO Quality Assurance Program, your dental office has agreed to participate in the Dental Quality Assurance Program and to provide Anthem with member encounter data.

The encounter data that Anthem receives from your office is utilized to monitor the level of services our network is providing our members, your patients, as well as to identify problem areas in the network. Encounter data is also utilized to provide your office additional per patient visit and procedure specific supplemental compensation according to most of the plan designs.

As a reminder, there are three acceptable methods for your office to submit encounter data to Anthem:

  • Anthem supplied Patient Visit Record (PVR)
  • ADA claim form stamped “Encounter” in red
  • Automated dental practice management report

Anthem Blue Cross is the trade name of: In California: Blue Cross of California and Blue Cross of California Partnership Plan, Inc. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Blue Cross of California, Blue Cross of California Partnership Plan, Inc., Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. In 11 northeastern counties of New York: Anthem HealthChoice Assurance, Inc. and Anthem HealthChoice HMO, Inc. In these same counties, Anthem Blue Cross Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. Independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

CABC-DEN-063763-24

PUBLICATIONS: August 2024 Dental Provider Newsletter