Claims – Frequently Asked Questions

 

Do I have to be a participating provider to submit claims electronically to United Concordia Dental?
No, you do not have to be a participating provider to submit claims electronically. We accept electronic claims from all providers.

 

Why do I need a provider number for electronic billing if I do not participate?
You need a provider number because all electronic claims submissions require one. But you don’t actually need to include that provider number on the claim itself—we just need your National Provider Identifier.

 

When may I submit claims electronically?
Electronic claims submission is available 24 hours a day, 7 days a week.

 

How much does United Concordia charge to send claims electronically?
United Concordia does not charge providers to submit claims electronically using our online electronic claims tool, Speed eClaim®. If you utilize a clearinghouse or vendor, they may charge a fee. 

 

Can claims that require x-rays be submitted electronically?
Yes, claims requiring x-rays can be transmitted electronically, if you have the ability to send the attachment(s) through one of the attachment warehouse companies that United Concordia works with. Contact Dental Electronic Services at 1-800-633-5430 for a listing of these attachment warehouses.

 

How do I know if the procedures I perform are approved for electronic billing?
All current procedure codes are valid for electronic billing. If you have a question as to the validity of a code, use the procedure code lookup feature within My Patients’ Benefits. Speed eClaim also provides real-time edits of procedure codes.

 

Do I need to notify United Concordia before I send claims electronically?
No, if you are credentialed with United Concordia, you are eligible for electronic claim submission.

 

How will I know that my electronic claims were received by United Concordia?
Speed eClaim lets you know instantly that we have received the claim electronically. If you submit claims electronically through a clearinghouse or vendor, United Concordia sends the clearinghouse/vendor acknowledgement that we received the claim submission. They are then responsible for getting the acknowledgement to you.

 

If I receive a Confirmation Report marked "accepted" from my clearinghouse or vendor, does that mean my claims will process for payment?
No. An accepted Confirmation Report does not mean the claims will move directly into processing. Rather, the claims are first bounced against a series of edits to ensure that all information was completed and that information such as procedure codes and tooth numbers are valid codes used in the United Concordia processing system. A report called a Submission Summary is generated from these series of edits and is available to your clearinghouse within 24 hours after transmission. Your clearinghouse or vendor is responsible for contacting you for corrections.

 

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