Blue Cross Blue Shield of Michigan accepts claims on the 2006 and 2002, 2004 American Dental Association form. Call the ADA at 1-800-947-4746 to order the form.
Blue Cross Blue Shield of Michigan offers a self-addressed envelope, Form No. 2685, for returning dental claim forms. Use the Facility and Professional Provider Supply Requisition Form (PDF) to order a supply. Complete the form and mail or fax it to us using the contact information provided.