Coordination of Benefits

• When submitting electronic claims for coordination of benefits, please completely enter the other coverage information in the appropriate fields in your software. Please be sure to enter the primary payment dollar amount when submitting to Delta Dental for secondary coverage. Continue to retain the primary statement in your records. Incomplete information delays claims processing.

• Submit one electronic claim when the patient has dual Delta Dental coverage. Indicate additional coverage exists, either under Other Coverage or in the Notes section of your practice management software. Do not submit two separate claims.

Member Information

• Please ensure you are submitting the claim with the member's Social Security number.

• To avoid receiving an error message on provider name and license number, ensure information entered in the Payable Dentist portion of your practice management software matches what Delta Dental has recorded. Your name, license number, and tax ID must be in compliance with what you have filed with the IRS. Please call our Professional Relations department if you have any questions: 973-285-4063 or 973-285-4064.

• Prevent headaches and unnecessary problems! Ensure the information is entered properly in your practice management software. Check with your software vendor concerning correct punctuation, spaces, capital letters. Example: Entering Delta Dental Plan of New Jersey as DDPNew Jersey might be interpreted as DDPNebraska, because the software might transmit the first five characters to the clearinghouse, ("DDPNe"), who then interprets NE as Nebraska. Please note we now go by Delta Dental of New Jersey (we no longer use the word "Plan" in our company name). Or, one space may be required between a state abbreviation and zip code. Or, hyphens may need to be removed from your modem's telephone number.

• You do not have to be a Delta Dental participating dentist to submit electronic claims.

• Delta Dental accepts all claims electronically!

Narratives

• When a procedure requires a narrative, don't send the claim on paper! Use the Remarks field in your computer software to enter the narrative, and submit the claims electronically. We accept up to 103 characters in the Remarks field.

Orthodontics

• Attention Orthodontists! Submitting your claims electronically will reduce the amount of "back and forth" correspondence normally associated with ortho claim submission. For example, if treatment is a full case, indicate in the remarks/comments section of your practice management software the total length of treatment time; or if submitting for an appliance only, indicate the reason for the appliance. This will eliminate mail requests for additional information and your claim will process faster!

Periodontics

• Please use our toll free fax number for electronic claim submitters when we request perio charting on a previously submitted electronic claim. Please indicate the claim number on the charting. The fax number is 1-800-494-4137.

Students

• Indicate the patient's student status in the appropriate field in your practice management software ("yes," "no," "full-time," "part-time" and the college/university name) to avoid a request for additional information and a delay in processing your electronic claim. If there is not a designated field for student status, please use the Remarks field.

X-rays

• When submitting electronic claims with multiple periapical x-rays, please use procedure code 0220 for the first x-ray, and procedure code 0230 for each additional x-ray.

• When x-rays are required to process an electronic claim, please write the corresponding Delta Dental claim number (referred to as a carrier reference ID on your claims status reports) on the x-ray, along with the patient's name and the dentist's name, and mail it to the following special post office box for electronic claim submitters:
  
  ECS Unit
  P.O. Box 600
  Parsippany, New Jersey 07054-0600
  
  X-rays submitted without Delta Dental's assigned claim number will delay processing.

• Delta Dental accepts scanned images or digital attachments via the Internet through the use of NEA (National Electronic Attachment). Attachments can be sent the same day as the claim. For more information on NEA, please call 800-782-5150, extension 2.

• Do not submit paper copies of your electronic claim transmission report with your x-rays. This will delay processing.

The Notes or Remarks field

• When submitting an electronic claim to Delta Dental, you can indicate the following in the Notes or Remarks field in your dental practice management software:

  • Narratives

  • Completion date: crown/bridge cementation, deliver partial or denture, finish root canal

  • Periodontal pocket depths

  • Orthodontic information

  • Student status

  • Pre-treatment estimate voucher number (when submitting for payment when a pre-treatment estimate was previously done)

  • Discounts, waiver of co-pays, or deductibles

  • COB: Indicate primary approved amount (if the primary carrier has reduced your approved fee)

  • NEA attachment number