|
Providers wishing to participate in the CareFirst BlueCross BlueShield / CareFirst BlueChoice (CareFirst) Dental provider network are required to submit credentialing information.
To ensure that CareFirst obtained correct information to support credentialing applications and made fair credentialing decisions, providers have the right, upon request, to review this information, to correct inaccurate information and to obtain the status of the credentialing process. Requests can be made by calling 443-921-0676 or by emailing DentalContracting@CareFirst.com.
CareFirst accepts the Maryland Uniform Dental Credentialing Form and the Coalition for Affordable Quality Healthcare (CAQH) Universal Credentialing Datasource application.
To avoid confusion and unexpected out-of-pocket expenses for members, all providers in the same practice must participate in the same provider networks.
Providers of dental care services seeking participation on both a dental plan organization panel and a carrier panel for medical care services will need to complete both the Maryland Uniform Credentialing form and the Maryland Uniform Dental Credentialing Form.
Maryland Uniform Dental Credentialing Form
The Maryland Uniform Dental Credentialing Form is a state mandated form that is accepted by all health plans in Maryland. Please review the following instructions when completing this mandated form:
- Please complete all sections, including any sections or pages that are not applicable to your practice. If a section is not applicable to your practice, please indicate N/A on that specific page or section when submitted.
- A Dental Billing Authorization Form also must be completed and submitted along with the Maryland Uniform Dental Credentialing Form, to be considered for participation in the network(s).
The Maryland Uniform Dental Credentialing Form must be:
- updated every time there are changes to information to ensure accurate claims processing and directory information
- filled out every three years for re-credentialing
CAQH Universal Credentialing Datasource Application
The CAQH credentialing system compiles and organizes comprehensive data from more than 600,000 providers in 23 health plans nationwide at no cost to providers. As a result, providers avoid redundant submission of credentialing information to participating health plans and health care organizations. Only one completed application per provider is needed.
CAQH Universal Credentialing Datasource:
- is compliant with the Maryland Uniform Credentialing Form regulations
- streamlines the data collection and submission process into a Web enabled system
- allows you to update your information, so you do not have to fill out a new form every three years
If you are interested in using CAQH's Universal Credentialing Datasource, complete the top portion of the CAQH Dental Provider Data Sheet and fax it to 410-720-5080. You will receive a CAQH ID number that allows access to the online application.
| If you have already completed the application through another CAQH member insurance company:
Then, we can access your data to begin the credentialing process.
|
|
