CareFirst Will Continue to Cover Dental Services with In-Network Providers
In order to expedite reimbursement of out-of-network dental claims for members of American Maritime Officers and their families, AMO Plans has officially reverted to the claims process used prior to January 2024. All AMO Plans participants should pay out-of-network dental providers directly for service and submit claims for out-of-network dental service directly to AMO Plans. CareFirst will no longer be processing out-of-network dental reimbursements.
CareFirst will continue to provide direct coverage for AMO Plans participants for in-network dental services, as they have been since January 2024. For AMO members utilizing in-network dental providers, the transition to CareFirst has proved beneficial. Members have experienced significant cost savings and have been able to take advantage of CareFirst’s negotiated discounts at the time of service. Another convenience for in-network dental service is the elimination of the process of filing reimbursement forms.
CareFirst was responsible for administering reimbursements for all out-of-network claims and many AMO members reported long delays in receiving reimbursements. Despite multiple meetings and advisory sessions between AMO Plans and CareFirst over several months, the processing of out-of-network dental claims did not improve significantly. As a result, the Medical Plan Trustees have returned to the previous process for out-of-network dental claim reimbursement.
This change is currently in effect. All participants should verify if their provider is participating (by using the link below). If you continue to utilize an out-of-network provider please follow the instructions below.
For out-of-network dental care, AMO Plans participants will need to pay the provider directly, fill out an Application for Benefits form and submit it along with the provider’s receipt or invoice for services. Additionally, proof of payment, such as a credit card receipt, should be included with the claim to ensure timely processing by AMO Plans. The invoice or receipt submitted with the Application for Benefits form must show that the invoice was paid by the AMO Plans participant.
The entire process can be completed on the AMO Plans website. The Application for Benefits form can be filled out, saved, and uploaded online, and images of receipts and invoices can also be uploaded to complete a claim. Please select the “MY BENEFITS – SECURE SITE” link on the AMO Plans website. Participants with any questions can contact the Medical Plan office at (800) 348-6515 extension 12.
While the transition to CareFirst has brought significant benefits for participants using in-network providers, the challenges faced by those seeking out-of-network care highlighted the importance of continuously assessing and adjusting plan administration. The feedback from members has been instrumental in shaping these changes, and AMO Plans is dedicated to providing quality service and support.
Some participants have reported difficulties with finding in-network dental care providers for use with CareFirst in their areas or the lack of availability of in-network dental care providers in their areas. To locate an in-network dental provider in your immediate area, or to determine if one is available, use the link below.
On the CareFirst search page, enter your city and state or zip code. When the “Select a Network” menu is presented, select “BlueDental” from the options menu. You will be asked questions about the type of care you are seeking. Should you need additional assistance locating a provider, please contact the Medical Plan office at (800) 348-6515 extension 12.