Dental Overview

Overview

CareFirst’s dental business supports dental providers in delivering high-quality care to our members. This section covers network participation, member products, and an overview of self-service options available to you and useful for efficient collaboration between your dental offices and CareFirst.

Provider Networks

CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (CareFirst) contract with independently practicing licensed healthcare practitioners who provide services covered under the member’s plan’s dental benefits. Dentists must be licensed in the state where the member receives the service and must be within the CareFirst service area, which includes Maryland, Washington, D.C. and Northern Virginia.

Your office’s participation in our dental provider networks help serve a diverse patient base and offer simplified administration, competitive rates, and extensive member resources. Joining ensures dental professionals can focus on care, supported by a trusted organization. A deeper dive is available in our “Dental Provider Networks” training, found on our Learning and Engagement Center in the dental suite of on-demand learning resources.

Note: To avoid confusion and unexpected out-of-pocket expenses for members, all providers in the same practice must participate in the same provider networks.

Dental Products

CareFirst provides health insurance and administrative services to 3.3 million people in Maryland, Washington, D.C., and Northern Virginia, and supports a nationwide dental network through the National Dental GRID. These products include:

More information about CareFirst’s dental plan offerings can be found in our Dental Insurance Plan Basics learning resource, found on our Learning and Engagement Center.

Self-Service Options

CareFirst recommends utilizing self-service channels for routine inquiries such as eligibility, benefits, or claims information. This approach enables resources to be allocated more effectively towards matters that require specialized attention.

Most customer service phone calls concern routine problems, so support for these requests is moving to electronic channels. When contacting our service lines, you will be directed to an appropriate self-service channel for quicker assistance.

• CareFirst Direct

CareFirst Direct is a convenient tool available at https://provider.carefirst.com/prv/#/register that gives you fast access to the information you need.

• CareFirst on Call

CareFirst on Call is an Interactive Voice Response (IVR) system that allows providers to retrieve verbal CareFirst member eligibility, benefits, deductibles, maximums, and claim status over the phone.

• Electronic Claim Submission

CareFirst) supports electronic claims submission and automatic posting of remittance advice and electronic funds transfer. We strongly encourage providers to complete the “electronic round trip.” Electronic transactions help facilitate streamlined claims submission, reconciliation and direct deposit of funds to your bank accounts.

For more information about our self-service resources, please access our Guidelines for Provider Self-Service resource.

These assets are designed to streamline day-to-day operations, minimize paperwork, and enhance efficiency for dental practices. By leveraging these resources, providers can dedicate more time to patient-centered care and less time to administrative tasks, ultimately supporting optimal patient health outcomes and your satisfaction.

Still Can’t Find What You’re Looking For?

Contact the Dental Team. Requests can be made by calling (443) 921-0676 or by emailing dentalcontracting@carefirst.com.