News Flash

Important Information about Dental Utilization Management

Effective March 1, 2009, CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice, Inc. (CareFirst) will introduce a more comprehensive Dental Utilization Review process to maintain a consistent Utilization Management Program. The enhanced utilization review process will require the submission of radiographs, periodontal charting and/or other supporting documentation, as appropriate for select dental procedures.

For your convenience, please see the revised Quick Reference Guide for Required Attachments (535KB, 2 pgs.) listing, by category of service, the procedure codes or procedure code range and the specific documentation required for submission with the claim.

Please refer to the Quick Reference Guide for Required Attachments (535KB, 2 pgs.) to help identify the necessary documentation associated with each claim you submit, as this will ensure your claims are processed efficiently and in a timely manner. Please note that these guidelines apply to all dental claims received by CareFirst and CareFirst BlueChoice on or after March 1, 2009.

If you have any questions, please contact your Provider Service Area.

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