Tag Archives: electronic dental claims

DentalXChange Announces New Completely Integrated Attachment Service for ClaimConnect

facebook_attachment2_1200We are proud to announce our electronic claims attachment service is now completely integrated with ClaimConnect.

DentalXChange Attachment Service allows providers to electronically attach x-rays, periodontal charts, EOBs, narratives and any other documentation required by a payer to adjudicate a dental claim without having to use a third party application.

“Our goal in designing our attachment solution is to improve administrative efficiencies and control costs for payers and providers,” explained Scott Wellwood, President of DentalXChange. “By using one service to send claims and associated documentation, providers will simplify the claims cycle and expedite reimbursements.”

DentalXChange Attachment Service will allow providers to submit electronic attachments along with the claim, directly to Payers like Cigna, MetLife, UnitedHealthcare, among many others.

Along with sending solicited attachments without third party software, other features of the service include customizable attachment rules, attachment alerts and an online attachment archive.

“We want to empower our clients with services that perform at the highest level for less cost. We feel we have done that once again with DentalXChange Attachment Service,” he added.

To learn more about this innovative service, please call 800-576-6412 Ext. 455 or click here.

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Filed under Attachments, ClaimConnect, Claims, Dental EDI, Dental Office, dentalxchange

DentalXChange Selected To Provide All Payer Portal For Humana

DentalXChange has announced a partnership with Humana Inc. (NYSE: HUM) to launch a co-branded online portal supporting electronic data interchange (EDI) for the dental community.

Better Solutions for your Practice!

DentalXChange has designed and will operate the insurance company’s All Payer Dental Portal, allowing Humana’s dental providers to securely file insurance claims and conduct insurance-related transactions.

Scott Wellwood

“Our goal in supporting Humana’s All Payer Portal is to improve utilization management and increase administratice efficiencies” Scott Wellwood 

“Our goal in supporting Humana’s All Payer Portal is to improve utilization management and increase administrative efficiencies for providers,” explained Scott Wellwood, President of DentalXChange. “By increasing the speed at which providers of dental care can gather and utilize insurance information, we will be helping to improve the overall healthcare experience for patients, while accelerating revenue cycles for each of Humana’s dental providers.”

Through the portal, providers will have the opportunity to interact more directly with Humana, completing all dental EDI transactions at reduced or no cost. Features include the submission of claims and predeterminations, checking patient eligibility and benefits, obtaining the status of claims and receiving remittance information to balance claim payments. Transactions can be conducted directly on ClaimConnect or through integration with popular dental software programs.

“Humana is one of the nation’s leading health and well-being companies,” Wellwood said. “We look forward to working with Humana to further streamline the company’s EDI processes and reduce costs for their providers.”

“DentalXChange’s EDI tools will help empower Humana’s dental providers with the ability to eliminate paper and manage their entire revenue cycle, from eligibility verification before a patient’s visit, through the receipt of the electronic remittance advice and payment,” he added.

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Filed under California Dental Association, ClaimConnect, Claims, Dental EDI, E-Credentialing, EDI Claims, Humana, Uncategorized

Why Are My Dental Insurance Claims Rejected?

The hours wasted into investigating why an insurance claim gets rejected can drive a person crazy and waste many quality hours that could be spent with patients.rejected dental claims

To help alleviate the aggravation, we talked to Lindsey Schurman, Manager of Client Services at DentalXChange, to find out how you can avoid being placed in a straightjacket and get those important claims paid quickly.

What are the top reasons claims are rejected? 

The three issues we see most often are:

  1. The provider’s information does not match what is on file with the payer
  2. The patient info does not match what is on file with the payer
  3. The patient is no longer covered under policy

How can these be avoided? 

The best way to avoid a rejected claim is to check the patient’s eligibility when they first make an appointment. This is easily done through ClaimConnect’s Real Time Eligibility. After eligibility is checked, make sure the patient’s ID card matches what is in their chart. This will help avoid discrepancies between information on file and what the payer has on record. After a client receives rejection, the advice we share is to verify that all the information matches what is on file with the payer.

When DentalXChange investigates a rejected claim we ask the following questions:

May I please confirm the patient info to make sure we have matching claims info?

Asked the payer to confirm:

  1. The Patient and Subscriber Name
  2. Dates of Birth
  3. Member IDs
  4. Addresses
  5. Genders
  6. Group/Plan numbers
  7. Plan Effective Date

May I also confirm that the correct Provider information listed on the claim is on file?

Ask them to confirm:

  1. Rendering and Billing
  2. Name
  3. NPI
  4. TIN
  5. Address
  6. License number
  7. Any applicable provider ID or Taxonomy code

One of these issues is usually the reason a claim gets rejected.

How does a product like ClaimConnect help?

When submitting a claim through ClaimConnect, the program focuses on minimizing rejections by checking claims for the preventable errors. We call these validation errors. Validation errors prevent claims from being sent when the information does not match what the payer requires. They can range from incorrect procedural codes to incomplete provider information. These errors are flagged and allow you to fix any discrepancies before the claim is submitted to the payer.

This saves a ton of time dealing with rejected claims. Of course, if anyone is having an issue with claims rejections, they can always give us a call. Our customer service representatives will be happy to help resolve any issues you might be having.

Thanks for taking the time to help us, Lindsey!

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Filed under ClaimConnect, dentalxchange, EDI Claims

DentalXChange Helps Shape the Future of Dental EDI at NDEDIC Summit

Huntington beach is a great place to hang 10, build a sand castle and get a great tan. They don’t call it Surf City for nothing! But this year it was the perfect place to catch a wave of a different sort. The EDI wave of change!

NDEDIC banner

 The National Dental EDI Council (NDEDIC) is the only organization to unite insurance groups, clearinghouses and dental practices in promoting the value and increasing the utilization of electronic commerce within the dental industry. NDEDIC’s EDI Summit provides a conference for these stakeholders to meet and advance the value and utilization of electronic connectivity in the dental community.

 This year, NDEDIC hosted its 2013 EDI Summit over the week of April 29th thru May 2nd  in Huntington Beach, CA. The conference featured a wide range of events and seminars  and brought together Payers, Practitioners and Clearinghouses from all over the country, dedicated to furthering the advancement of Electronic Data Interchange in the dental industry.

Lizzy Jones DentalXChange employees moderated many of these seminars, like, Bill Dachelet, Operation Manager and past Benjamin D. Ward Award recipient, who hosted the EDI Basics Workshop: Talk HIPAA to Me. Tom Mort, a Benjamin D. Ward Award recipient and Director of Product Integration for DentalXChange, help moderate two events: 835 Remittance Advice 101 and 835 Driven to New Directions by UIF. And not to be out done, Lizzy Jones, Director of Sales and Retention, helped present the Town Hall Meeting: Sharing Best Practices for Marketing EDI Usage.

  The SumIMG_1058mit was not all work though. People who attended also got treated to a day at theIMG_1159 Aquarium of the Pacific, in Long Beach, CA, or a day of golf at Mile Square Golf Course. Le Ann Eyres-Morris, Director of Channel Partners for DentalXChange, help host a meet and greet at the Longboard Restaurant and Pub. It all culminated with a fantastic beach party featuring live music and bonfire with a build your own s’mores bar!

DentalXChange president and last year’s Chairman of the Council, Scott Wellwood, presided over the final event of the week, the Awards luncheon and State of NDEDIC Report. He passed his gavel to this year’s Chairwoman, April Rimpley, Vice President of Group Customer Connections & Operations of Ameritas.Scott Wellwood

DentalXChange has been a member of NDEDIC for more than 20 years,”  said Wellwood. “Our active participation and leadership during that time has proven instrumental in driving success for our company and numerous process improvements for our customers.  It is truly a unique organization and the annual Summit provides tremendous learning and networking opportunities and showcases the best of what our industry has to offer.”

 All the events at NDEDIC’s EDI Summit 2013 were lively, educational and ended with great give and takes from the audience that will help shape the future of EDI in the dental industry.

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Filed under Dental EDI, dentalxchange, EDI Claims, Electronic Claims, NDEDIC, Uncategorized

DENTALXCHANGE OFFERS GUARDIAN CLAIM STATUS TRANSACTION

Providers can now check Guardian claims status online through DentalXChange

DentalXChange is proud to announce that The Guardian Life Insurance Company of America (Guardian), now offers online claims status verification through DentalXChange.

Dentists can now easily check the status of their Guardian claims online through DentalXChange. This can eliminate the need for time consuming phone calls to check on the status – making the process easier and faster for dental offices.

“Guardian is committed to making it easy for dentists to work with us,” says Dr. Richard Goren, 2nd Vice President and National Dental Director for Guardian. “One of the ways to meet that commitment is by offering an array of online capabilities, like claims status verification, to ease administrative duties.”

“We are excited to support Guardian in the development of the new transaction as together we have a goal to deliver a complete EDI process for the Guardian providers” said LeAnn Eyres, DentalXChange Director of Channel Partners.

If you would like any more information or have any questions about claims status verification, please do not hesitate to call us at 800-576-6412 Ext. 467.

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Filed under ClaimConnect, Claims, Dental Office, dentalxchange, Uncategorized

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

There’s an App for that!

DentalXChange is eager to increase efficiency for you and your office, so we created the Activity Snapshot after much demand from our clients.  This can be installed to your PC or Mac, and it is even available for on-the-go access for your iPhone or iPad.

What is the Snapshot?

The Snapshot is just that, a quick glimpse that gives your office an idea of how many claims/pre-treatments you’ve sent in the last day, 30 days or 60 days–you choose.   We bring your office real-time reporting on the ClaimConnect side, PayConnect  side and BillConnect side as well.

This is an exclusive DentalXChange product which is available now to all our offices for free, and the offices that have it so far can’t stop raving about it.  The best part about the Activity Snapshot is that you simply log in and leave it open throughout the day with no effect to other office services.  The Snapshot automatically updates every 2 minutes, giving you the most up-to-date report.  Have a validation error?  Know immediately and head to our website to fix it.  Did a claim get rejected? No problem–with the Snaphot, you’ll know immediately.   Here is a quick look at the DentalXChange Activity Snapshot:

Activity Snapshot Example

Here, we see how many claims our test office has billed for the past day, 30 days, and 60 days.  It even gives us a total dollar amount for what has been billed for this time period, which is quite possibly the most popular feature.

The snapshot is fully customizable to work best for you.  Give our support team a call today at 800-576-6412 x 452 if you’d like help on installing our FREE Snapshot, or follow the easy to read instructions here.

What’s better, is you can download the Snapshot to your iPhone or iPad for on-the-go access.  You can even switch easily between multiple practices if you are managing multiple offices.

Leave a comment on how you think the Activity Snapshot can help your practice!

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Filed under BillConnect, Claims, dentalxchange, PayConnect