• United Concordia Dental (UCD) will administer claims and Customer Service beginning January 1, 2022 for Highmark BCBSWNY patients who have moved onto Highmark’s system
• As this is a gradual process, please click here to check to see if your member has moved to a new 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

• Dental providers are strongly encouraged to register with United Concordia to continue serving Highmark New York dental members

• 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

• 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

• 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) member ID cards have the same FEP ID number and may not include the information above.

• Yes, short educational recorded 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 access these webinars, which will be available in early December on our dental resource page to offer additional guidance to providers

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

• 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

• 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)

• 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)

• 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
• Please note: when submitting a claim to UCD, you must include the patient’s member ID number without the 3-letter prefix (Ex. ABC123456789 must be submitted as 123456789). Claims submitted with the 3-letter prefix on the member ID may be rejected

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

• Yes, paper claims can be sent to the following PO boxes:
• FEP claims should be sent to:

Dental Claims Administrator
PO Box 69401
Harrisburg, PA 17106-9401

• All other dental claims should 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
• Please note: when submitting a claim to UCD, you must include the patient’s member ID number without the 3-letter prefix (Ex. ABC123456789 must be submitted as 123456789). Claims submitted with the 3-letter prefix on the member ID may be rejected

• 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

• Dental and Oral surgery claims should be sent directly to United Concordia Dental for migrated members. Any codes that are not covered under the member’s Dental plan will automatically cross over to Highmark’s system for potential medical coverage. Any claims submitted to UCD for procedures not covered under your patients’ dental plan will be automatically routed to Highmark’s system for medical coverage review.

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

Please note: FEP has its own dental fee schedule

• 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)

• 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

• 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

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

• 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
  • Please refer to the New York Health Care Reform Orthodontic Grid on the UCD website for additional claim submission requirements
• 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)

• 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

• Dental providers interested in joining the network serving Highmark New York dental members should contact United Concordia
• Medical dental providers, i.e., those providing dental services that are paid under the medical plan, should continue to follow the existing process for credentialing through Highmark