FREQUENTLY ASKED QUESTIONS- CLAIM SUBMISSION
Q. What is the fastest way to submit a TDP claim?To quickly submit a claim, utilize United Concordia's free online Speed eClaim® system. Submitting claims via Speed eClaim® results in a quicker processing time, resulting in faster payments. |
Q. I want to submit a hard copy claim. Where should I send it?United Concordia Companies, Inc. To avoid delays in processing, please use the appropriate P.O. Box. |
Q. Do I have to be a network provider to submit claims electronically to United Concordia?No, you do not have to be a network provider to submit claims electronically. We accept electronic claims from all providers. |
Q. 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. |
Q. 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. |
Q. 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. |
Q. My patient's claim has been rejected due to incomplete data. What do I do now?Submit a new claim with the required information. If submitting through Speed eClaim®, you can utilize the system’s instant online editing and resubmission capabilities. |
Q. When is it necessary to submit radiographs?Diagnostic requirements are located in the Forms and Resources section of our website. NOTE: You will need your My Patients' Benefits or Speed eClaim® logon and password to access this information. |
Q. Are radiographs required for the removal of impacted wisdom teeth?Pretreatment radiographs are required if the patient is age 31 and over or 14 years and younger. Patient specific documentation is also required for review. |
Q. Are radiographs required for implants?Radiographs are required for patients under age 14. |
Q. Besides x-rays, is there any additional information that should be submitted with the claim?If the services are crowns, inlays/onlays, build-ups, bridgework, or prosthetics it's very important to include the prescribed date and the insertion date. If any information is not available send a narrative/diagnosis of why the service(s) was provided, and an explanation as to why x-rays are not available. |
Q. My patient has dual dental coverage. Is the other insurance explanation of benefits required?If the other insurance is primary, an explanation of benefits is required. |
Q. I submitted a claim for my patient and received a letter requesting my license and tax identification. Why is this information required?Contractually, United Concordia is required by the Federal Government to verify licensure and tax identification of all providers rendering services covered under the TRICARE Dental Program. |