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United Concordia Dental (UCD) Member - Frequently Asked Questions (FAQs)

Highmark Blue Shield of Northeastern New York has selected United Concordia Dental (UCD) to administer claims and manage customer service for our dental plans. Throughout 2022, your Highmark BSNENY patients will gradually be moved onto UCD’s system. Here, you can find answers to frequently asked questions. 

UNITED CONCORDIA DENTAL

What is changing for Highmark BSNENY dental coverage?

  • United Concordia Dental (UCD) will administer claims and Customer Service beginning January 1, 2022 for Highmark BSNENY patients who have moved onto Highmark’s system
  • As we affiliate with Highmark, we will begin to integrate our claims processing systems and move our members onto Highmark’s systems gradually to better take advantage of some of Highmark’s technology solutions
  • Some workflows and policies will change as your patients gradually move to UCD’s systems
  • For more information about the affiliation and phased integration, click here

Please note: Federal Employee Program (FEP) members will not move over to UCD until 3/1/2022, although their medical coverage will move over to Highmark on 11/1/2021

Do I need to join a new network/become a participating provider with UCD?

  • No, you will remain in our network, but you will need to register at unitedconcordia.com so you can access their Dental Reference Guide, online tools, patient information and policies
  • If you are interested in joining UCD’s dental provider network, click here

How do I register for United Concordia Dental?

  • You can register any time by visiting unitedconcordia.com
    • Click on Business Services and select Dentists
    • Then click Log in/Create an Account at the top of the screen
    • You will need your NPI and Tax ID number to create an account
  • If you are a current UCD provider, and have already registered to use their website, you will not need to re-register

How do I register for Electronic Fund Transfer (EFT) payments?

  • If you are currently signed up for EFT with UCD, then you will automatically receive electronic payments
  • If you’re not signed up for EFT, we strongly encourage you to do so by following the instructions below:
  • Go to unitedconcordia.com and log in with your username and password
  • Select Electronic Funds Transfer (EFT)
  • Click ‘Request PIN’
  • For security reasons, the PIN will be mailed to your office’s mailing address within 7 to 10 days
  • Upon receipt of the PIN, sign in to unitedconcordia.com and enter the PIN into the system before it expires (30 days from request date); you have three tries before it locks you out
  • Enter your bank account information for your practice, group, and/or individuals that submit claims
  • Upon completion of this step, you will begin to receive your payments electronically by the next payment cycle

During the affiliation, how will I know if my patients have been moved onto UCD’s system? Will my patients have a new ID number?

  • When your patients have moved onto UCD’s system, patient ID cards will:
    • Include a new patient ID number that should be updated in your system
    • Direct you to file electronic claims using your United Concordia Payer ID
    • Provide the Harrisburg address for mailing paper claims
    • Include the UCD Dental Customer Service phone number

Please note: Federal Employee Program (FEP) members will not move over to UCD until 3/1/2022 – their ID cards will have the same FEP ID number and may not include the information above.

Will education be provided on the services UCD offers?

  • Yes, webinars are being planned to educate providers on how to register with their website, use the UCD MyPatients'Benefits portal, file claims, attach images/x-rays, and more
  • Network dental providers will receive information about how to register for these webinars, which will take place in early December
  • A video and power point presentation will be made available on our dental resource page to offer additional guidance to providers

DENTAL BENEFITS

How do I check benefits/eligibility for my patients on Highmark’s and UCD’s system?

  • Once you have registered with UCD, you can log into MyPatients'Benefits to access this information

Will my patients ID cards be different for patients who are on UCD’s system?

  • Patient ID cards will direct you to file electronic claims using your United Concordia Payer ID, provide the Harrisburg address for mailing paper claims and include the UCD Dental Customer Service phone number

Will dental policies change?

  • Beginning January 1, 2022, we will adopt UCD’s dental policies for your patients moved onto UCD’s systems
  • UCD’s dental policies can be reviewed in Section 6 “Standard Policy and Procedure” of the PPO Dental Reference Guide
  • Please note that there are new imaging requirements for certain diagnostic, restorative, endodontic, periodontic, fixed prosthodontic and oral surgery codes
    • A full list can be found in section 6 of the PPO Dental Reference Guide
  • UCD’s PPO Dental Reference Guide can be accessed in the Reference Guides & Documents section on United Concordia’s Office Resources page by clicking here and scrolling down to Dental Reference Guides and selecting the PPO Dental Reference Guide (you will need to be registered with UCD/log in)

Will UCD provide predeterminations?

  • Yes, you can request predeterminations electronically or via paper claim form
  • For details on how to request a predetermination, please consult UCD’s PPO Dental Reference Guide
  • UCD’s PPO Dental Reference Guide can be accessed in the Reference Guides & Documents section on United Concordia’s Office Resources page by clicking here and scrolling down to Dental Reference Guides and selecting the PPO Dental Reference Guide (you will need to be registered with UCD/log in)

DENTAL CLAIMS

How do I file dental claims electronically for my patients?

  • You can use a clearinghouse/vendor using your United Concordia payer ID
    • Click here for a list of approved UCD clearinghouses
  • You can also submit through United Concordia’s Speed eClaim®
    • Once you are registered, you can log into unitedconcordia.com and click File a Claim
    • If you have internet access and an Internet Explorer 9 or above, Chrome, Safari or Firefox web browser, you can use Speed eClaim® to submit claims electronically to UCD

Who can I call with questions about electronic claim submission?

  • UCD’s Dental Electronic Services at 1-800-633-5430 from 8 a.m. to 5 p.m. EST

Can I file paper claims?

  • Yes, paper claims can be sent to:

Dental Claims Administrator
PO Box 69421
Harrisburg, PA 17106-9421

  • Paper claims must be submitted on the paper ADA claim templates; 2012 or 2019 claim forms are preferred and available at ada.org

MEDICAL CLAIMS

Are there any changes that will affect how I file medical claims?

  • Yes, beginning in November 2021 and throughout 2022, patients will be moved onto Highmark’s system
  • The time frame for these moves mostly will be based on each group or individual’s scheduled renewal date
  • On January 1, 2023 all patients will have been moved onto Highmark’s system, when Medicare Advantage, Essential Plan, individual markets and the last large group and ASO patients are moved over

How will I know where to send medical claims?

  • Whether your patient is on Highmark’s system or the legacy BSNENY system, you will continue to submit all medical claims through ASK-EDI as you do today

PAYMENTS

Are fee schedules changing?

  • No, our dental fee schedules will remain the same for patients on UCD’s system and those who are still on our legacy BSNENY system
  • To access our dental fee schedules, click here (log in required)

Please note: Federal Employee Program (FEP) members will not move over to UCD until 3/1/2022, although their medical coverage will move over to Highmark on 11/1/2021; FEP has its own dental fee schedule

Will my payments still come electronically?

  • Yes, if you have registered for electronic fund transfer (EFT) through UCD
  • If you have not signed up for EFT, we strongly encourage you, once you’ve registered with UCD, to sign up for EFT (see instructions above)

PROVIDER SERVICE

How do I reach Dental Customer Service at UCD?

  • Access MyPatients’Benefits, to verify patient enrollment, benefit information, claim status, and processing details; you can also chat with a live customer service representative while logged into your MyPatients’Benefits account
  • FEP - 1-800-234-6008 from 8 a.m. to 4:30 p.m. EST
  • Commercial Business - 1-866-298-8548 from 8 a.m. to 8 p.m. EST (Note: Phone line will be active after January 1, 2022)

Who can I call with questions about electronic claim submission and portal issues?

  • Dental Electronic Services is available at 1-800-633-5430 from 8 a.m. to 5 p.m. EST
  • They can assist with your website registration process and password issues, as well as provider portal issues including payments and EOBs, Speed eClaim®, EFT, existing predeterminations, adding attachments to claims, and updating provider information

Where can I mail inquiries?

Dental Customer Service
PO Box 69420
Harrisburg, PA 17106-9420

 

ORTHODONTIA

Are there any changes to orthodontia coverage?

  • The coverage is the same, but processing and payment is different
  • Instead of requiring new claims to be filed every month, providers will need to submit one claim with the orthodontic treatment plan including the total treatment fee, the length of treatment, and the banding date; no further claim submissions are required
  • UCD will set up a treatment plan to systematically generate monthly payments until treatment is complete; lump sum payments will be issued for those treatment plans where UCD’s total treatment liability is $1,000 or less
  • Pre-authorization is still required for the Health Care Reform Essential Health Benefits
  • For more details about orthodontic treatment policy, visit section 6 UCD’s PPO Dental Reference Manual  
  • UCD’s PPO Dental Reference Guide can be accessed in the Reference Guides & Documents section on United Concordia’s Office Resources page by clicking here and scrolling down to Dental Reference Guides and selecting the PPO Dental Reference Guide (you will need to be registered with UCD/log in)

DENTAL MANUAL

How do I access UCD’s Dental Manual?

  • UCD’s PPO Dental Reference Guide can be accessed in the Reference Guides & Documents section on United Concordia’s Office Resources page by clicking here and scrolling down to Dental Reference Guides and selecting the PPO Dental Reference Guide
  • You will be asked to log into your account, so you will need to be registered with the UCD website to access the Dental Reference Guide online
  • To create a new account, visit unitedconcordia.com, and then click Log in/ Create an Account in the menu at the top of the screen on the right
  • You will need your NPI and Tax ID to create an account
  • UCD’s PPO Dental Reference Guide is routinely updated to provide timely and accurate information

Tools and Resources for Non-UCD Members

Dental Eligibility Tool

Use our Dental Eligibility Tool that was design just for you! Type in the member's ID to view their dental coverage.

Dental Reference Manual

View our Dental Reference Manual for information regarding dental products, services and claim information.

Dental Provider Search Tool

Select "Dental Providers" under the "I don't know my plan" drop down (at the top of the page) to begin your search.