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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

How do I register for electronic fund transfer (EFT)?

Answer: CareFirst Dental currently has EFT connectivity with Change Healthcare. Click the link or contact them below:

Are there any special requirements in order to receive EFT)?

Answer: Yes, you must:

  • Submit your claims electronically
  • Receive an Electronic Remittance Advise (ERA-835)*

* Some clearinghouses may have specific requirements. Contact them for details.

How long will it take for my EFT enrollment to begin

Answer: Contact your clearinghouse for specific timing. Once CareFirst receives notification that you have been enrolled, your EFT will begin with the first voucher issued after the change occurs..

What claims are included on the EFT?

Answer: Once enrolled, all claims processed by CareFirst will be included on the EFT.

Will I continue to receive my paper voucher after my EFT deposits begin?

Answer: No, your paper vouchers will be discontinued.

When should I contact my clearinghouse?

Answer: Contact your clearinghouse if you:

  • Need a copy of your ERA-835
  • Received your EFT but not your ERA-835
  • Need to make changes to your banking or contact information

When should I contact CareFirst?

Answer: If your EFT deposit was not received or it is late, contact Provider Services. For the appropriate contract information, please refer to www.carefirst.com/electronicclaims.

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