Tag Archives: dental plans

DENTALXCHANGE OFFERS GUARDIAN ENHANCED ELIGIBILITY TRANSACTION SYSTEM

Updated eligibility transaction system, now live with DentalXChange, will reduce costs by lowering the volume of eligibility request phone calls

ORANGE COUNTY, Calif. – January 31, 2012 – DentalXChange, an Irvine, CA, based technology company that specializes in providing online solutions to connect dentists, patients, and insurance companies, is proud to announce that The Guardian Life Insurance Company of America (Guardian), is the latest to offer enhanced online eligibility capabilities through DentalXChange.

Guardian worked with DentalXChange to offer dentists the ability to use their online service to obtain the “Top 50 Elements,” a list published by the Uniting the Industry Forum (UIF) of the most requested pieces of information needed when verifying patient eligibility.

These enhancements will allow dentists to receive comprehensive patient plan details, eliminating the need for time-consuming calls to the call center and making the process of checking eligibility faster and easier. Using the online functionality, dental office staff can properly present expected reimbursement and co-pay information so patients can make informed dental decisions at the time of service.

“Guardian is committed to making it easy for dentists in our network to work with us and manage their patient administration, while also helping our members better understand their benefits,” says Dr. Richard Goren, 2nd Vice President and National Dental Director for Guardian. “One of the ways to meet that commitment is by providing cutting edge, easy to use online services – DentalXChange helps us to do that.”

“DentalXChange is excited that Guardian saw the added value in these enhancements” said LeAnn Eyres, DentalXChange Director of Channel Partners and former Committee Chairman of the UIF. “We are looking forward to additional insurance companies following as they see the benefits of our enhanced system.”

About DentalXChange
Since 1989 DentalXChange (DXC) a subsidiary of EDI Health Group, Inc. (EHG), has earned industry-wide acclaim and recognition for pioneering the web-based dental EDI solutions industry. Today DXC has grown to support a current client base of over 12,000 healthcare offices. Headquartered in Irvine, CA, DXC accounts for more than $4 billion in healthcare claims. Through its own clearinghouse, ClaimConnect and PatientConnect portals, the company processes nearly 20 million EDI transactions, consisting of more than 15 million healthcare claims annually.

For more information or to schedule an interview with LeAnn Eyres please contact Asef Quader at 877.932.2567 x234 or email aquader@dentalxchange.com. For any other inquiries please visit: www.DentalXChange.com

About NDEDIC and the Uniting the Industry Forum
The National Dental EDI Council (NDEDIC) is the only organization to unite all stakeholders in promoting the value and increasing the utilization of electronic commerce within the dental industry. NDEDIC provides a community portal created to facilitate the exchange of information and unite stakeholders (payers, providers, vendors and clearinghouses), advancing the value and utilization of electronic connectivity in the dental community. The Council’s forum, “Uniting the Industry” is formed of stakeholders who support the development of useable standards for EDI transactions within today’s operations.

For more information please visit: www.NDEDIC.org

About Guardian
A mutual insurer founded in 1860, The Guardian Life Insurance Company of America and its subsidiaries are committed to protecting individuals, business owners and their employees with life insurance, disability income insurance, dental insurance products, and offer funding vehicles for 401(k) plans, annuities and other financial products. Guardian operates one of the largest dental networks in the United States, and protects more than six million employees and their families at 115,000 companies. The company has approximately 5,000 employees in the United States and a network of over 3,000 financial representatives in more than 80 agencies nationwide.

For more information about Guardian, please visit: www.GuardianLife.com

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Filed under Claims, Dental Office, dentalxchange

Dental Plans: 64 Dental Plans Moving to EDI with DentalXChange

Great news for our Dental Offices!  The following 64 dental plans are now accepting claims from DentalXChange electronically.  This means that your dental practice will see a quicker turnaround time on your claims.  Here’s the list of 64 dental plans that will now accept electronic dental claims from DentalXChange.  If you aren’t sending claims through our clearinghouse yet, give our office a phone call at 800-576-6412 x 467 to get started!  We are compatible with most dental softwares, including EagleSoft, Dentrix, EasyDental and many more!

HMAA/ Hawaii Western Management Group-

They went live with the Co-Branded “All Payer Portal” and direct for claims, October 2011.

Payer ID# 48330
Par Plus Status
No Enrollment Required

Excited to announce that Operating Engineers has gone live for the first time for dental claims!

Operating Engineers Health and Welfare

Pasadena, CA

Payer ID#            OEL12
Transaction:       Claims
Paper to EDI –    Par Plus Status
No Enrollment

Direct, just went live hours ago, November 16th!

Providence Administrations

Payer ID#            PAS01
Transaction:       Claims
Payer Status       PT
Claims Mailing Address for reference:    16414 San Pedro #800, San Antonio, TX  78232
Paper to EDI
No Enrollment

Benefits Administration Services

Payer ID#            41205
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment
Claims Mailing Address for reference: P.O. Box 14208, Ridgeland, MS 39157

Brokerage Concepts
Payer ID#            51037
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment

Claims Mailing Address for reference: P.O. Box 61553, King of Prussia, PA 19406

Cap Rock Health Plans

Payer ID#            CAPHP
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment

Claims Mailing Address for reference: 4401 82nd Street, Unit 1200, Lubbock, TX 79424

Co-Ordinated Benefit Plans

Payer ID#            14829
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment

Claims Mailing Address for reference: P.O. Box 20594, Clearwater, Fl  33763

Hammer and Gainer

Payer ID#            97258
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment

Claims Mailing Address for reference: 909 Lake Carolyn Parkway, Suite #1900, Irving, TX 75039

Managed Care of America
Payer ID#            56162
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment

Claims Mailing Address for reference: P.O. Box 330, Canonsburg, PA  15317

P5 Health
Payer ID#            87068
Transaction:       Claims
Payer Status       PT
Paper to EDI
No Enrollment

Claims Mailing Address for reference: 860 Paris Street, Pittsburgh, PA 15220

Dental Select

Payer ID#            DSL01
Transactions       Claims
Paper to EDI-     Par
No Enrollment

Direct, went into Production Sept. 2011

Excellus and Associated Blue Cross Blue Shield of New York Plans

Payer ID# EXC01
Transaction:       Claims
Paper to EDI – Par Plus
No Enrollment

Univera of New York

Payer ID# 16105
Transaction:       Claims
Paper to EDI – Par Plus
No Enrollment

Blue Cross Blue Shield of North Dakota

Payer ID#            CX004
Transaction:       Claims only
Paper to EDI –   Non- Par
Enrollment is required and special testing. Please contact Enrollment@dentalxchange.com

Direct Connection

Associated Third Party Administrators

Payer ID#            ATPA1
Current Connection, new plans, direct connection
Par Plus Status
No Enrollment Required

ATPA Supported Plan Name:                                                      Billing Address:

Automotive Industries                                                                  P.O. Box  23263    Oakland     94623

California Service Employees                                                      P.O. Box 24515      Oakland      94623

Central Coast                                                                                     P.O. Box   24516      Oakland     94623

Laborers of Southern California                                                 P.O. Box   23812     Oakland     94623

School District No. 1                                                                        7600 SW Mohawk St Tualatin, OR 97062

Oakland Firefighters                                                                       P.O. Box   24263     Oakland       94623

Portland Area UFCW local Union 555                                      7600 SW Mohawk St Tualatin, OR 97062

Joint Labor Management Retail                                                  7600 SW Mohawk St Tualatin, OR 97062

Plumber and Ship fitter Union  290                                           7600 SW Mohawk St Tualatin, OR 97062

Southern California Local Union 831 Health & Trust Fund,  P.O. Box  23015      Oakland       94623

San Diego County Teamsters Union                                         P.O. Box  919029    San Diego   92191

Teamster Local 856                                                                          P.O. Box  24513      Oakland       94623

Heat and Frost Asbestos Workers                                            P.O. Box   2590           Pasadena   91102

Heat and Frost Insulators Local Union 16                               P.O. Box   24263      Oakland       94623

Liberty Dental Plan

Master Payer ID#             CX083
Transaction:                       Claims, eligibility will follow in 2012
Par Plus
No enrollment

This is live and direct. You are welcome to send all claims to CX083 but they have over 20 plans that are broken out by payer ID.   See below:

Payor ID

Payor Name

Mailing Address

City

State

ZIP

CX083

LIBERTY Dental Plan

PO Box 26110

Santa Ana

CA

92799

LDP01

Alameda Alliance  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Rocky Mountain Hospital & Medical Service, Inc. – OSB High & LOW (Liberty Dental)

P.O. Box 401086

Las Vegas

NV

89140

LDP02

Blue Cross of California – OSB High & Low ( Admin  by LIBERTY Dental)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Health Plans of Kentucky – OSB High & Low ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Health Plans of Kentucky – PPOB & PPOD ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Health Plans of Virginia – OSB High & Low   ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Health Plans of Virginia – PPOB & PPOD ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Health Plan – HMOD & HMOG ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Insurance – OSB High & Low ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem Insurance  – PPOB & PPOD  ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Blue Cross Blue Shield of Wisconsin – PPOD  ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Blue Cross of California – PPOA  ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Blue Cross of California – Plan SS10 & SS20  ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Community Insurance Co.- HMOA & PPOB ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Community Insurance Co. – PPOD & PPOF  ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

EmpireHealthChoice Assurance – OSB Low & PPOB ( Admin. by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

EmpireHealthChoice HMO – ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Healthy Alliance Life Insurance – PPOB  ( Admin by LIBIRTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP02

Anthem HMO Colorado – HMO-B  ( Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP04

Cal Optimal -OneCare (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP05

Care 1st Health Plan Medicare Advantage (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP05

Care 1st PHP LA & San Bernadino County   (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP09

EasyChoice Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP10

Golden State Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP11

Health Net 21 – LA & Sacramento  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP11

Health Net Healthy Families A, B & C   (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP11

Health Net Los Angeles PHP  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP11

Health Net Sacramento GMC  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP12

IEHP  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP13

LA Care Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP14

MD Care Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP15

MGM Resorts International  (Admin by LIBERTY Dental Plan)

P.O. Box 401086

Las Vegas

NV

89140

LDP16

Molina HealthCare (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP17

Ohana Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP18

Ozark Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP19

PALMS Casino Resort  (Admin by LIBERTY Dental Plan)

P.O. Box 401086

Las Vegas

NV

89140

LDP20

Physicians United Plan-PUP (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP21

Sands Bethworks Gaming  (Admin by LIBERTY Dental Plan)

P.O. Box 401086

Las Vegas

NV

89140

LDP22

Santa Clara Family Health Plan  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP23

Venetian  (Admin by LIBERTY Dental Plan)

P.O. Box 401086

Las Vegas

NV

89140

LDP24

Wellcare  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

LDP25

WellPoint  (Admin by LIBERTY Dental Plan)

PO Box 26110

Santa Ana

CA

92799

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Filed under Claims, dentalxchange