Frequently Asked Questions
- Does a provider have to be par to submit claims electronically to United Concordia?
- Why do we need a provider number for electronic billing if we are non-par?
- When may I submit claims electronically?
- How much does United Concordia charge the provider to send claims electronically?
- May claims that require x-rays be submitted electronically?
- How do I contact software vendors/clearinghouses that have been approved for electronic claims submission to United Concordia?
- How do I know if the procedures I perform are approved for electronic billing?
- Do I need to notify United Concordia before I send claims electronically?
- How will I know that my electronic claims were received by United Concordia?
- If I receive an accepted Confirmation Report, does that mean my claims will process for payment?
Does a provider have to be par to submit claims electronically to United Concordia?
No, a provider DOES NOT have to be par to submit electronically. We accept electronic claims from par and non-par providers.
Why do we need a provider number for electronic billing if we are non-par?
All electronic claims REQUIRE a provider number. If this provider number is not on the electronic submission, the claims will be rejected.
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 the provider to send claims electronically?
United Concordia does not charge providers (par or non-par) to submit their claims electronically. If you utilize a clearinghouse or billing service a per claim charge may be incurred.
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May 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 through one of the attachment warehouse companies that United Concordia works with. Contact Dental Electronic Services at (800) 633-5430 for a listing of these attachment warehouses.
How do I contact software vendors/clearinghouses that have been approved for electronic claims submission to United Concordia?
We offer a complimentary listing of those software vendors, billing services and clearinghouses that are currently in production with United Concordia. You can obtain a copy of this listing by calling our support line at (800) 633-5430.
How do I know if the procedures I perform are approved for electronic billing?
We keep and update a list of procedure codes that are eligible for electronic billing. You can obtain a copy of this listing by contacting our support line at (800) 633-5430.
Do I need to notify United Concordia before I send claims electronically?
Yes, you must call Dental Electronic Services at (800) 633-5430 and speak to one of the staff members to enroll for Electronic Claim Submission.
How will I know that my electronic claims were received by United Concordia?
We follow every electronic transmission with a Confirmation Report that confirms receipt of your electronic file. However, files can be rejected. If the file is marked ''rejected'' on your Confirmation Report, you would need to fix any errors and resubmit the file electronically until you get an ''accepted'' confirmation. If a clearinghouse or billing service submits your electronic claims, this report is sent to them and they are responsible for contacting you for corrections.
If I receive an accepted Confirmation Report, 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 download electronically 24 hours after transmission. If a clearinghouse or billing service submits your electronic claims, this report is sent to them and they are responsible for contacting you for corrections.
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