Tag Archives: electronic dental claims

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
Advertisements

Leave a comment

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!

Leave a comment

Filed under BillConnect, Claims, dentalxchange, PayConnect

Do You Want to Send Electronic Claims, but Don’t Have a Dental Software? It’s possible!

So you don’t have a dental software in your office.  You use your desk calendar to schedule appointments and you know all the ADA CDT claim codes by heart.  You spend about two hours a day filling out dental claim forms and mailing them out, and another hour per day fixing the ones that have gotten sent back to you with errors.  Some days you’re tired of having to make the corrections, and some days you stay overtime because there is just too much paperwork to catch up on.  However, you think all this has worked out just fine because after all, the claims are getting paid and your paycheck has never bounced.

And oops!  You got a rejection notice back from an insurance company for Jane Smith–you were missing information on the claim form. You forgot to specify the surface on the composite filling and now the insurance company is asking for the surface (shouldn’t the insurance companies know anyway that you’ve been working in insurance for 10 years and you know that D2330 is for one surface!).  After fixing the claim and sending it back, it will be another 4 weeks before this claim gets paid, making the grand total time about 7  weeks.

Sending electronic claims is easy

Thankfully, DentalXChange offers web-based online claim submission, which makes it easy to send claims and pre-estimates without an expensive dental software.  Few offices managers know of the web-based claim portal with DentalXChange’s Direct Data Entry package.  No software to buy, unlimited training/technical support, and of course, this service is extremely simple.

Dr. Vincent Vivirito’s office in Des Plaines, IL switched from paper claims to web-based claim connect in April.  Erica, who has worked at the office for 12 years now, says, “The whole system overall is pretty simple and easy!  You get paid from insurance a lot faster.  Mailing claims would take a month and a half to two months and now we have payments within 2 weeks already.”

Our partner insurance companies enable you to send claims for FREE (list available upon request), while our non-partner insurance companies accept claims for just 37 cents per claim.  The best part–DentalXChange has the ability to send all your claims and pre-estimates for you, even if we don’t have an electronic connection with the payer, we drop the claims down to paper for no additional cost.

Reasons you should make the switch:
1)  Save Time: Quicker claim turnaround time (2-15 days for electronic claims vs. up to 45 days for paper claims!)
2) Save Money: Dr. Jeffrey West from Chapel Hill, NC switched to DentalXChange in April as well and says, “It has lowered my overhead in the sense that less time has to be spent filling out forms by hand and a claim submitted electronically is cheaper than paper, envelope and a stamp.”
3) Reduce Date Entry: Store patient data online so you don’t have to reenter in the next time the patient visits
4) Go Green: Sending electronic claims is a great way to be more eco-friendly and environmentally cautious
5) It’s Easy!:  Erica from Dr. Vivirito’s office agrees that you “don’t have to be a pro at the computer to figure out electronic claims.”

Dr. West adds, “I’m not using a practice management software package and have all Mac computers in my office, so DentalXchange’s browser-based interface has been perfect.  My staff caught on quickly and it has become second-nature to enter claims.  We are thrilled with the service.”

We hope this helps you with your decision to switch to electronic dental claims!  It’s easier than you think.  Give our office a call at 800-576-6412 x 467 if you have any questions.  Remember, we always offer a 30-day worry free guarantee, which means if you’re not satisfied, you don’t owe us a dime.

Leave a comment

Filed under Claims, dentalxchange

Improve Claim Acceptance and Get Paid FASTER!

We understand that being an office manager has its many challenges–handling the office’s finances, patient appointments, making the doctor happy, submitting claims…. we get you!  It’s easy to make a mistake every now and then–especially when submitting claims.  We here at DentalXChange know it’s not uncommon to accidentally type in the incorrect procedure code, select the wrong surface or name the incorrect quadrant.  Or oops! That patient is actually insured by Aetna but you accidentally put MetLife as the insurer.  It’s estimated that this results in an added $1.5 billion annually in added administrative costs in medical offices, and we are pretty sure it results in the same amount of loss in your dental practices.  So how do you improve claim acceptance?

Paper Claim Process
First, you have to understand the difference between a paper claim and electronic claim.  A paper claim takes longer to process because oftentimes, a real-life person is reviewing the details of the claim.  If they find an error with the claim, it’s mailed back to the office to fix the error, sent back to the insurance company and it goes through the review process once again!  This process takes much longer (an average turnaround time of 45 days!) so it’s not surprising that it adds to the cost of administrative work. (Think: extra hours at work, paper costs, stamps…)

Electronic Claims Process
Electronic claims, on the other hand, are reviewed electronically by a computer.  The claim values are read and matched up to the patient’s file.  It’s a much quicker process and rejections are turned around more quickly.   But if you still want to avoid all those rejections, DentalXChange can help you!

The activity snapshot updates every 2 minutes to provide accurate information to your office

Our state of the art claim validation system takes less than 5 minutes to scan your claims and find invalid information.  DentalXChange thoroughly checks your claim codes and matches them to your teeth numbers.  If there are any issues with the claims, we mark them for errors and let you know almost immediately via your Activity Snapshot.  Simple as that!  We make it easy for your offices to fix the errors right away by going back to ClaimConnect to fix those errors instantly online.

Five Tips to Improve Claim Acceptance:
1) Double-check the patients’ subscriber ID or Social Security Number when taking their insurance information
2) Always grab the Group Number– some insurance companies, like United Health Care, require the group number be submitted with electronic claims
3) Make sure you spell the patient’s name exactly as it is on the card — If it says “Jonathon Patient”, make sure you don’t write “Johnny Patient” or “John Patient” on the claim.  Some insurance companies are particular about this.
4) Match the procedure codes to the tooth numbers.  Anterior codes are different than posterior codes – we see this error very often!
5) Sign up for an X-Ray/electronic attachment validation system like our NEA FastAttach Integration. It will save you the guess work!  Get an alert in as little as 10 minutes if a claim requires an attachment instead of having to wait for the insurance company to request an X-Ray, mail it, and wait for the claim to be processed.

DentalXChange’s claim validation process checks for all of these items on your ADA 2006 dental claims forms, but it’s always a good idea to know what helps your claim’s get accepted more quickly!

Let us know if you have any tips to improve your claim acceptance!

1 Comment

Filed under Claims, dentalxchange

Electronic Dental Claims Reduce Costs & Improve Claim Turnaround Time

We don’t see why you wouldn’t send your claims electronically!  However, according to the American Dental Association, “In 2008, 51 percent of all dental claims were submitted to dental benefits companies electronically and 49 percent of dental claims were submitted on a paper claim form. ”  Since 1989, DentalXChange has helped offices reduce overhead costs and speed up claims processing time by being the solution for sending electronic claims.  Sometimes, even we can’t believe how low our rates are in comparison to paper claims or other clearinghouses!

Benefits of Electronic Dental Claims

We like to make things easier for our dentists.  With reimbursements being low and operating costs skyrocketing, there is no better time than now to go electronic.  The average turnaround time for paper claims is estimated to be around 45 days while electronic claims are processed in 15 days or less on average.

Send Claims with the Click of a Button

We try to help those we meet understand just how much money we can save their practice if they send claims electronically.  Electronic claims help to virtually eliminate paper cost, stamp costs and reducing labor costs, we don’t see why you wouldn’t send your claims electronically!

We spoke to a doctor the other day whose office was using Easy Dental to print and mail his claims to insurance companies.   Having been practicing in the New York area for over 20 years, his practice was really busy and he had a strong patient base— he said that he saw 400 or so patients per month!  He wanted to reduce overhead costs due to the rising cost of dental care and business expenses.  He called in just to find out how much we charged per claim, and was pleasantly surprised.

His office was spending 44 cents per stamp, paying two employees to process claims, and buying paper by the caseload.  He was frustrated with claim rejections and having to resend claims by paper when his staff made an error.  When we told him we would charge him just 25 cents per claim with his Easy Dental Software* and catch errors with our Validation Process he was amazed at how much money that would save his practice!

We directed him to the Claim Calculator  on our website to find out his annual savings and he was impressed with the savings, and scheduled the appointment to sign up.

How much does a paper claim really cost?

Overall, a paper claim costs an office more than just the 44 cent stamp; it can cost an office anywhere from 70 cents – $1.80 per claim when factoring in labor, paper , envelope  and ink/toner costs!

We’ve saved this dentist and many others like him thousand of dollars a year on electronic claims, and hope we can save you the same.  Click here to read some of testimonials.    Give us a call today to see how we can save your practice money at 800-576-6412 x 467, or fill out a request for information here and one of our representatives will contact you within 1 business day.

Has DentalXChange saved you money on claims?  Share your stories in the comments section!

*rates dependent on Practice Management Software–please call for your per claim rate!

1 Comment

Filed under Claims