A-1: To submit paper claims for ConnectiCare members, you must use the below claims mailing address: ConnectiCare (DentaQuest) PO BOX 463 Milwaukee, WI 53201 A-2: Submit via the DentaQuest provider portal.
Full Answer
How do I file a pre estimate with ConnectiCare?
Oct 15, 2021 · You can submit the dental reimbursement form, or call us and we will mail you the form. Always keep a copy of all documents for your records. You must submit your claim to us within 12 months of the date you received the service. Check your Cost Sharing guide for what is covered and how much you will have to pay.
How do dentists submit claims to Medicare?
X-rays, including full-mouth or panoramic x-rays, one every 36 months; bitewing x-rays, one every six months. Employers can also add a ConnectiCare dental plan with both preventive and …
How do I request a reimbursement from ConnectiCare?
Refund ConnectiCare for an overpayment. Download PDF. Claim submission for unlisted procedure or service code. Submit a claim with unlisted CPT code (s) and/or unlisted services. …
How do I Bill my Dentist for ConnectiCare?
What is the number to contact ConnectiCare?
You may direct any questions regarding claims to Provider Services at 1-877-224-8230. ConnectiCare has a fraud and abuse hotline that is available to members, providers, employees, and government officials.
Is ConnectiCare a primary plan?
ConnectiCare commercial plan is primary (as long as the Employer group has over 100 employees); Medicare is primary if the employer has less than 100 employees. Spouse (over 65) of active employee who is under 65. ConnectiCare commercial plan is primary and Medicare is secondary.
How long does it take to receive EFT payments from ConnectiCare?
When you select to receive funds electronically, you can expect to receive your payment directly into your bank account within 48 hours of each claims payable date.
What is the number for ConnectiCare fraud?
If you suspect fraud or abuse, contact our Special Investigations Unit at 1-888-4KO-FRAUD ( 1-888-456-3728) or via email at [email protected]. Medicare PPM/7.20. Claims submissions. Claim Submission.
Is spouse eligible for Medicare?
Spouse of active employee is under 65 and eligible for Medicare due to total disability. ConnectiCare commercial plan is primary (as long as the Employer group has over 100 employees); Medicare is primary if the employer has less than 100 employees. Spouse (over 65) of active employee who is under 65.
Claim resubmission request form
Provide the required information to process your request for an adjusted or corrected claim.
Electronic funds transfer authorization
Request payment directly into your bank account on the same day we issue a reimbursement check.
Clinical review preauthorization request form
Request authorization of services or procedures included under ConnectiCare’s preauthorization requirements.
Infertility treatment preauthorization request form
Request authorization for infertility therapy, including infertility prescription drug requests.
For Massachusetts providers only
Submit preauthorizations for select imaging procedures to NIA/Magellan via the following:
Cardiac Imaging preauthorization form
Request preauthorization for Myocardial Perfusion Imaging (MPI), Stress Echocardiogram or Multiple Gated Acquisition Scan (MUGA) services.
Advance health care directives
Provide your patients with information on how to create an advance directive.