Dental Claims Submission FAQs

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EDI

How does the electronic submission process work?

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.

How does my office begin submitting dental claims electronically to CareFirst?

Answer: If you do not currently use a vendor, contact one of our preferred clearinghouses.

What is CareFirst’s payer ID code?

Answer: Please use payer ID code 00580 to submit dental claims electronically.

What provider number should I use when submitting 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.

Who can I call regarding problems with my electronic claim submissions?

Answer: Please direct questions to your clearinghouse.

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EFT

Will our office be able to receive electronic funds transfer (EFT) from CareFirst?

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.

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