To get started with electronic claims submission, simply contact your practice management system representative. They will provide all the necessary instructions for submitting electronically.
There are no special enrollment needs to submit claims electronically to Northeast Delta Dental. All services, with the exception of the procedures requiring attachments, may be submitted electronically.
Requests for predetermination may also be submitted electronically. However, to receive payment when services are completed, the predetermination number should be indicated in the comments section when submitting an electronic claim for previously predetermined treatment.
There are three basic steps to follow to submit your claims electronically:
Your software vendor will advise you how to enter claim information using your computer system. Be sure to enter all information completely and accurately. Processing criteria is the same as for paper claims - if x-rays and documentation are needed to process a paper claim, the same information is required to process an electronic claim.
Your vendor will advise you how to use your modem to transmit claim information.
The vendor will also advise you how to retrieve reports. Although Delta Dental does not, at this time, send a direct confirmation that a claim has been received, we send that information to the clearinghouse and/or vendor, which sends it to you in various reports. Reports also serve as your notification that attachments are required or that claims were rejected for missing information.