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.
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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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