Dental Electronic Capabilities
Electronic Data Interchange (EDI)
To support our paperless initiative and improve your claims processing experience, CareFirst strongly encourages participating and non-participating dental providers to submit dental claims and pre-treatment estimate requests electronically. Secondary Coordination of Benefits (COB) submissions should not be submitted electronically.
If you do not currently submit claims electronically, contact one of our preferred clearinghouses:
- Change Healthcare at 1-844-217-1199 (email is firstname.lastname@example.org)
- DentalXChange at 800-576-6412 (ext. 452 for support; ext. 455 for enrollment services)
- Tesia Clearinghouse, LLC at 800-724-7240
Electronic Funds Transfer (EFT):
Change Healthcare also offers electronic fund transfer (EFT) services. With EFT, CareFirst will discontinue delivery of paper remittance notices. Your Electronic Remittance Advice (ERA-835) will be delivered by your clearinghouse and will serve as your new payment voucher. You can also access PDF copies of your voucher on CareFirst Direct.
The ERA-835 will include payment details and HIPAA adjustment and remarks codes necessary for you to reconcile your patient accounts. If a copy of this information is needed, contact your clearinghouse.
View our EFT FAQs or contact your clearinghouse with any questions regarding EFT-specific enrollment capabilities.
The following information is required when contacting your clearinghouse to enroll for EFT services:
- National Provider Identifier (NPI) – Billing NPI
- Provider Federal Tax Identification Number (TIN)
- Reason for Submission : New/Change/Cancel Enrollment
- Requested EFT Start/Change/Cancel date
- Practice/Provider Name
- Financial Institution Information (including Financial Institution Name, Financial Institution Routing Number, Type of Account (Checking/Savings), Provider's Account Number
CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (CareFirst) have several solutions to facilitate the electronic submission of dental attachments. Electronic attachments include x-rays, dental charting, narratives and letters of medical necessity, pathology reports and approved Pre-Treatment Estimate (PTE) vouchers for claim payment. CareFirst has partnered with the following vendors to provide easy access to electronic attachment capabilities:
- Change Healthcare at 844-217-1199 or email@example.com
- DentalXChange at 800-576-6412, ext. 452 for support and ext. 455 for enrollment services
- Tesia Clearinghouse, LLC at 800-724-7240.
By clicking the vendor links above, you will leave the CareFirst website and access a vendor website. The vendor is solely responsible for the services it provides.