Q: Do
I need Electronic Claims Submission?
A: Take
this simple test:
-
Do you submit 20 or more claims per week?
-
Are you currently computerized?
-
Do you experience cash flow disruptions?
-
Are you inundated with paperwork?
-
Do you want to reduce the number of rejected
claims?
-
Do you want to spend more time on treating
your patients and less time on filling out claim
forms?
If you answered YES to one or more of these
questions, then you are a good candidate for
electronic claim submission!
Q: Can
I submit claims with diagnostics?
A: All claims can be sent electronically.
If a claim needs diagnostics,
we will request them. However, you can send a claim
manually if you prefer.
Q: Can
I submit claims requiring COB (coordination
of benefits)?
A: Yes. Primary carrier payment information
should be provided in the appropriate field. We
also accept and process prime COB claims
and dual (Delta Dental primary and secondary) claims.
Q: What
about Pre-Treatment Estimates?
A: Pre-Treatment Estimates can be submitted
electronically.
Q: Does
Delta Dental receive claims from more than one
clearinghouse?
A: Delta Dental receives claims from the
following clearinghouses:
ENVOY
Corporation
Healtheon/WebMD (formerly Med
E America)
Q: Where
can I go for additional information on electronic
claims submission?
A: NDEDIC - e-mail ndedic@ndedic.org or
visit their website: www.ndedic.org.
In addition, Delta Dental has clearinghouse and
software vendor agreements which can further benefit
the participating
dentist through discounts and other cost-savings.
Ask your dental network coordinator for more information.
- Q: Do
I have to maintain a hard copy of my patient
records if I’m submitting electronic claims?
-
- A: No, as long as
the licensee complies with the requirements defined
in the amended rule.
-
- Q: What
if I make a mistake entering data?
-
- A: Make the correction
as a new entry (to generate a permanent audit
trail that is maintained in the patient record)
and resubmit electronically.
-
- Q: How
often should I back up my data?
-
- A: Back up your
system nightly. Maintain quarterly back-ups,
storing the last three quarters onsite, and the
fourth quarter (annual) back-up offsite.
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