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Frequently Asked Questions

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Q. What claims am I charged for?
A: All claims that are accepted on the Clearinghouse Reports are forwarded on to the insurance company and you will be charged for those claims.

Q. How do I know if a claim was successfully submitted?
A: You’ll receive a Confirmation Report as part of your eTrans (the eClaims software for DENTRIX) Submission Report. Each claim is assigned a unique routing number that will show up in your batch processor immediately following your transmission. If you do not receive this report please contact eServices Customer Support at 1-800-734-5561 and press 1.

Q. Now that I send claims electronically, does that mean I do not have to follow up with insurance companies?
A: We recommend that you follow up with insurance companies on any outstanding claims that have been submitted, but not settled after 30-45 days. Electronic claims is a service that provides you with faster claims submission and tracking information. The insurance companies are still responsible for processing and paying your claims.

Q. What if an insurance company says they didn’t received my claim?
A: Verify the claim information (name, social security number, date of birth, group ID, etc.) with the insurance company. If the correct information was submitted and the claim was submitted through eTrans, contact eServices Customer Support at 1-800-734-5561. If the claim was submitted electronically, eServices will research the claim to determine the status. If the claim was mailed to the insurance company, eServices will verify the insurance company’s mailing address with you.
Note: eServices is unable to research any claim that is older than six months from the submission date. Please run an Insurance Aging Report from your practice management software on a regular basis to ensure that claims are not aging more than 90 days.

Q. What if I need a claim resubmitted?
A: To resubmit a claim, you will need to fix any incorrect information, delete and recreate the claim in your Ledger and resend it with your daily batch of electronic claims.

Q. How many claims can I/should I send at any given time?
A: You can submit up to 100 claims per batch. eServices suggests that you submit all of your claims for any given day in one large batch either at the end of your work day or at the beginning of the following work day. Offices who 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 concise.

Q. How do I cancel or delete a claim once it has been transmitted?
A: Claims are processed in “real-time.” That means as soon as your claim is received processing begins. Therefore, we are unable to delete claims. Please be sure and review your validation report carefully before transmitting your claims to eliminate the possibility of sending claims you did not intend to send. All claims go through a duplicate check when received that will reject many of the claims that are sent more than once.

Q. Do I have to transmit claims from the same computer every time?
A. No. As of eTrans 3.0, reports and claims can be sent and viewed from any computer in the office.

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, eServices will print that claim to paper and mail it to them for you. You are charged no additional fees for processing of these claims.

Q. Do I need to notify anyone if I add a new dentist to my practice?
A: Yes. It is extremely important that you notify eServices Enrollment prior to submitting claims for a new dentist. Otherwise, all claims for this provider will be automatically rejected. eServices Enrollment can be reached at 1-800-734-5561, option 4.

 

Sullivan Schein   Henry Schein Dental