Dental Documents / Guides
Current Matrices
2024 Dental Matrix – Over 212024 Dental Matrix – Under 21
Archived Matrices
2023 Dental Matrix – Over 212023 Dental Matrix – Under 21
2022 Dental Matrix – Over 21
2022 Dental Matrix – Under 21
2021 Dental Matrix – Over 21
2021 Dental Matrix – Under 21
2020 Dental Matrix – Over 21
2020 Dental Matrix – Under 21
SHCA 2019 Dental Matrix – Over 21
SHCA 2019 Dental Matrix- Under 21
Dental Prior Authorizations
Requests for dental services that require prior authorization can be submitted on our secure provider portal or complete the Dental Specialty Request Form and fax to 480-350-2217, email to: HCHdentaldeptHCA@azblue.com, or mail to:
BCBSAZ Health Choice
Attn: HC Dental Prior Authorization
8220 N. 23rd Ave.
Phoenix, AZ 85021
