- CareFirst CHPMD Providers: Starting 11/2, you can submit medication prior authorizations electronically through the CareFirst Provider Portal. For more information watch this recorded webinar or access the step-by-step guide.
- All Providers: Billing NPI Reminder:The billing NPI submitted on claims must match the billing NPI on file with CareFirst,NPPES and MPRIME(CareFirst CHPMD). If your billing NPI is not enrolled with CareFirst, add it here .
Change Healthcare notifying individuals of data breach. Learn more here.
Dental Claims Submission FAQs
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.
Answer: If you do not currently use a vendor, contact one of our preferred clearinghouses.
Answer: Please use payer ID code 00580 to submit dental claims 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.
Answer: Please direct questions to your clearinghouse.
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.
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..
Answer: Once enrolled, all claims processed by CareFirst will be included on the EFT.
Answer: No, your paper vouchers will be discontinued.
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
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.