Get answers to your questions about electronic claims processing.
Dentrix eClaims™ gives you the ability to accelerate the insurance claims process so you get paid faster. With a few clicks of the mouse, your insurance claims are created in Dentrix, validated, and electronically sent to your payors. The entire process only takes a few minutes but reduces your reimbursement time to days instead of weeks.
Here are the answers answers to commonly asked questions about submitting electronic claims:
Q: When can I send claims?
A: You can send claims 24 hours a day, seven days a week. However, the high-peak transmission time is from 2 p.m. to 6 p.m. Mountain Time, Tuesday through Thursday. To avoid busy signals and connection difficulties, you may want to schedule your claims submission for the early morning hours.
Q: What happens if I submit an electronic claim for a carrier who doesn’t process claims electronically?
A: You can conveniently send all your claims with Dentrix eClaims. Claims that can’t be processed electronically will be printed and mailed for you at no additional charge.
Q: How do I send a claim that requires X-rays or other documentation?
A: You can submit your attachments to the eServices department electronically along with the claim. Watch this video for instructions on how to include an attachment with a claim.
Q: How many claims can I send at a time?
A: You can submit up to 100 claims per batch. The eServices department suggests that you submit all of your claims for any given day in one large batch, either at the end of your workday or at the beginning of the following workday. Offices that submit one claim at a time frequently experience duplicate claim problems and confusion trying to match up reports. Submitting one large batch per day keeps your reports consolidated and easy to manage.
Q: How do I know if a claim was submitted successfully?
A: The status of each claim you send is listed on the Confirmation Report (part of the eTrans Transmission Report) that is delivered to the Batch Processor immediately following your transmission. If you do not receive this report, please contact eServices Customer Support at 800.734.5561, option 1.
Q: How do I resubmit a claim?
A: To resubmit a claim, you need to correct any erroneous information, delete and recreate the claim in the Ledger and resend it to the Batch Processor to go with your daily batch of electronic claims. The eServices department does not have the ability to resubmit claims for your office.
Q: How do I cancel or delete a claim once it has been transmitted?
A: Claims are processed in real time. That means processing begins as soon as your claim is received by eServices. Therefore, we are unable to delete claims. Review your Validation Report carefully before transmitting your claims to eliminate the possibility of sending claims you did not intend to send.
Q: Can I still submit a claim electronically if the insurance company is not found on the Electronic Payor List?
A: Yes. If a particular carrier does not accept claims electronically, the eServices department will print the claims to paper and mail them for you.
Q: Now that I send claims electronically, does that mean I don’t have to follow up with insurance companies?
A: We recommend that you contact insurance companies after 30 to 45 days to follow up on outstanding claims that have been submitted but not settled. eTrans claim submission is a service that provides you with faster claim submission and tracking information. The insurance companies are still responsible for processing and paying your claims.
Visit www.dentrix.com/eclaims or call 800.734.5561 to enroll in Dentrix eClaims or for help setting up your eClaims service.
Read Using eClaims to Improve Cash Flow and 10 Reasons eClaims Means Effective Insurance Management for more ideas about sending electronic claims.
Watch the eClaims Quick Start videos for information about setting up and using Dentrix eClaims.
Originally published in the Dentrix eNewsletter, November 2015