CareFirst Dental Manual

Important Phone Numbers

*For providers west of Route 123 in VA, please send all FEP claims and correspondence to the local plan.

BlueLine and FirstLine

BlueLine
If you use your CFMI provider number to submit a claim, call BlueLine to obtain a member's eligibility, benefit, deductible and claims status information.
410-581-3535 / 800-248-8410

FirstLine
If you use your GHMSI provider number or your Regional provider number to submit a claim, call FirstLine to obtain a member's eligibility, benefit, deductible and claims status information. FirstLine does not provide claims status information for members with FEP contracts.

• Commercial - 800-842-5975 or 202-479-6560;
• FEP - 202-488-4900 for Northern VA, DC, Montgomery and Prince George's Counties;
• All other MD FEP Providers-
  • Professional - 410-581-3568 or 800-854-5256
  • Institutional - 410-581-3567 or 800-321-2580

When calling BlueLine or FirstLine, have the following information available:

• Your provider number
• Member's identification number (without the 3-position alpha prefix)
• Member's date of birth
• Date the service was rendered if inquiring about the status of a claim
• For BlueLine only - Member's sex code/relationship to the subscriber as defined below:
  1. Male Subscriber
  2. Male Spouse
  3. Male Dependent
  4. Female Subscriber
  5. Female Spouse
  6. Female Dependent

Information provided by BlueLine and FirstLine does not constitute an approval or guarantee of benefits. To obtain further information about BlueLine, contact Dental Business Operations at 410-581-3541 or 800-272-1580.

Benefit Fax

Providers may obtain a computer printout detailing current dental benefits and history information for members covered by the Regional Traditional and Preferred dental products via fax. To request a Benefit Fax, you may:

• Call 866-891-2804 (option #2);
• E-mail request to dentaltbp@carefirst.com;
• Fax request to 410-720-5355

Please have the following information available and/or included in your Benefit Fax request:

• Provider Name
• Provider Tax Identification Number
• Fax Number
• Telephone Number
• Patient's Name
• Patient's Membership Number
• Patient's Date of Birth
• Request for required history information, if necessary

The information provided by the Benefit Fax does not constitute an approval or guarantee of benefits. This service is not available for FEP, NASCO or GHMSI Traditional Dental Plans. For further information, please contact Dental Business Operations at 866-891-2804.

CareFirst Direct

Participating providers may obtain real-time eligibility, benefit and claim status information for Regional Traditional and Preferred dental members* through CareFirst Direct. This web-based tool is free and allows you to make unlimited inquiries Monday through Saturday from 6:00 a.m. to 1:00 a.m. and Sundays 9:00 a.m. to 4:00 p.m.

Minimum System Requirements

Many of the functions in CareFirst Direct transfer substantial amounts of information over the Internet. A cable modem, DSL or other high-speed connection to the Internet is recommended. Low-speed modems (24.4 or less) may not provide satisfactory performance. The following software and hardware configurations are recommended:

To enroll in CareFirst Direct:

• Go to www.carefirst.com
• Click on the Providers & Physicians section
• Click on Electronic Services then select CareFirst Direct for Regional Dental Providers
• Choose Enrolling in the Get started section, complete the Registration Form and Submit

Your logon ID and temporary password will be e-mailed to you after completing the registration process. To begin using CareFirst Direct, simply follow the Get started instructions available online.

* This tool is not yet available for FEP, NASCO or GHMSI Traditional dental members.

The Dental Network

410-847-9060 / 888-833-8464
Provides dental services to CareFirst BlueChoice Dental HMO members.

Customer Service

Our Dental Business Operations Representatives are trained to respond to telephone and written inquiries regarding benefits and claim related issues. They are available Monday - Friday, 8:30 a.m. - 5:00 p.m. Please direct your call to the appropriate Provider Service area or refer to the back of the member's ID card.