Dental Claims Submission FAQs
Answer: Providers send electronic claims to CareFirst through a vendor. The vendor will review all claims and send you a transmission report to notify you of any errors they identify. Errors must be corrected and the claims can be resubmitted electronically.
Claims without errors are forwarded to CareFirst for processing and additional editing. You will receive a claims status report from the vendor to confirm receipt of claims by CareFirst and advise you if the claim was accepted, processed or rejected.
Answer: If you do not currently use a vendor, contact one of our preferred clearinghouses.
Answer: Please use payer ID code 00580 to submit dental claims electronically.
Answer: Your National Provider Identifier (NPI) must be used to identify your practice when submitting claims. Your billing and rendering NPI must be registered with CareFirst and match the information on our provider files.
If you have not submitted your NPI to CareFirst, complete the NPI Submission Form for Dental Providers and submit it today.
Without your NPI and Tax Identification Number (TIN), your claims may be delayed or rejected.
Answer: Please direct questions to your clearinghouse.
Answer: CareFirst has enhanced its electronic claims submission for dental providers, and is now providing Electric Funds Transfer (EFT) services, which allows providers to receive payments electronically. A clearinghouse manages provider enrollment and validation date.
We are also providing Electronic Remittance Advice (ERA) services as well, an equivalent to the Notice of Payment. Some clearinghouses auto-post the ERA and EFT to the patient’s account using the providers Practice Management System. Our new paperless submission capabilities are designed to improve efficiency, reduce administrative complexity and improve turnaround time. Claims for FEP members can now also be submitted electronically.