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Participating (PAR)
The Regence BlueShield of Idaho Participating (PAR) Network supports all traditional and indemnity lines of business, and serves as the default for all other networks in Idaho and Asotin and Garfield counties in Washington. As the default, the participating provider agreement is the baseline for all other provider agreements. All providers must sign a participating agreement before joining any other Regence BlueShield of Idaho provider network.
The PAR Network is offered by Regence BlueShield of Idaho and used for Regence Life and Health, Regence BlueShield of Idaho affiliates and subsidiaries other Blue Cross or Blue Shield Plans (Blue Plans) through The BlueCard® Program.
Regence PPO
The Regence BlueShield of Idaho Regence Preferred Provider Organization (Regence PPO) Network supports our preferred business as well as the Federal Employees Program. This network is available in Idaho and Asotin and Garfield counties in Washington.
The PPO Network is offered by Regence BlueShield of Idaho and used for Regence Life and Health, Regence BlueShield of Idaho affiliates and subsidiaries other Blue Cross or Blue Shield Plans (Blue Plans) through The BlueCard® Program.
Medicare Provider Networks
Regence MedAdvantage
Our Regence MedAdvantage products use the Regence BlueShield of Idaho MedAdvantage Network for in-network services with no referral requirements to access specialty care. Regence MedAdvantage provides all Part A and B benefits with additional covered services in one plan.
The Regence MedAdvantage service area includes Ada, Bannock, Benewah, Bingham, Boise, Bonner, Bonneville, Boundary, Canyon, Clark, Elmore, Fremont, Gem, Gooding, Jefferson, Kootenai, Latah, Madison, Minidoka, Nez Perce, Owyhee, Payette, Power, Shoshone, Teton and Twin Falls counties in Idaho and Asotin County in Washington.
Dental Networks
Contracting and Participating Dental Agreements
Regence contracts with multiple dental professionals, forming dental networks to meet our members' needs. In return we offer predictable reimbursement amounts and schedules, direct payment, and a pool of potential patients.
Participating Dental
The Participating Dental Network serves our members enrolled in our participating fee-for service dental plans in Idaho. Participating dentists are reimbursed according to our maximum allowable fee schedule. Payments and a remittance statement (which explains payment for services provided to our members) are sent directly to participating dental offices each week.
Caring Foundation for Children Dental Program
The Caring Foundation for Children Dental Program is a non-profit 501(c)(3) organization administered by Regence BlueShield of Idaho. The Caring Foundation provides free dental care to low-income, uninsured children whose families cannot afford private coverage and receive no government assistance such as Medicaid or CHIP. Families whose children meet eligibility guidelines (income thresholds, uninsured status, and under 19 years of age) receive a maximum of $1,000 of dental care per child per year for one year. Benefits are provided at no cost to qualified families.
Learn more about becoming a Caring Foundation dental professional by contacting Kathy Ellis at (208) 395-7741.
Participating Dental Agreements
Regence has standardized contracting practices and uses a single Dental Group Agreement for multiple providers using a Federal tax identification (ID) number. This agreement will cover all providers doing business under that tax ID number. Providers using their Social Security Number (SSN) will receive an Individual Dental Provider Agreement.
To participate on our dental networks:
- Review the list of provider types to determine if we contract with your specialty and if the network is open to participation.
- Complete a Provider Application
- Login to Provider Center
- Download the Provider Application in the Reference Library
- If you do not have a Provider Center account, please register
- Sign up for eContracting.
Application Checklist
The following is a checklist of documents that must be legible and included with your Application:
- A photocopy of your current state dental license (with license number, issue date and expiration date).
- A photocopy of your specialty certification(s)/or general anesthesia or conscious sedation permits, if applicable.
- A photocopy of your current malpractice insurance certificate (with policy number, levels of individual aggregate coverage and dates of coverage).
- A photocopy of your current Drug Enforcement Administration certificate(s), if applicable.
Dental Fee Schedule
How Payment is Calculated for Participating Dental Products
Every year we review Regence BlueShield of Idaho dental maximum allowable fees. A Maximum Allowable Fee is determined for each service or supply provided to your patients. The Maximum Allowable Fee amount is the total amount you can expect to receive in payment from the patient and payor combined.
Our Participating Dental Maximum Allowable Fee Schedules are available online using our Fee Calculator. Simply select "Dental" from the drop-down box to view our Fee Schedules. For more information about Dental Maximum Allowable Fees, please contact your local Professional and Provider Relations representative.
The fee schedule for both the Federal Employee Program (FEP) Basic Option and Standard Option dental plans can be viewed in the Reference Library available on the Provider Center. Login or register for an account.
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