Electronic Insurance

After creating electronic insurance forms for your patients, use the Electronic Insurance window to review and submit claims, and resubmit rejected claims.

This topic describes submitting electronic insurance claims: See "Insurance Forms" for details about creating paper insurance claims.

Click to OpenGenerate Claims to Submit

Depending on your office protocol, you may accumulate electronic insurance claims throughout the day or week. You then choose to transmit the pending claims to the processing clearinghouse as described below. See "Insurance Forms" for details.

Click to OpenSubmit Electronic Claims

After accumulating electronic insurance forms for your patients, open the Electronic Insurance window, and choose the claims you want to submit to the insurance clearinghouse. Be sure to review the claims and correct any omissions and errors before submitting to minimize the chance of rejection. You can also delete claims that were created in error, or no longer need to be submitted.

  1. Click to OpenOpen Electronic Insurance Window - You can open the Electronic Insurance window from either the ViewPoint toolbar or the ViewPoint shortcut menu Add-In options. If you have not saved your Claim Connect credentials in ViewPoint, you may be prompted to do so before continuing.

  2. Click to OpenFilter Claims to Review - Use the Office and Orthodontist filters to review only certain claims, or select to view all pending claims.

  3. Click to OpenDelete Claims - Choose the pending claim(s) that you do not want to submit (such as claims that produced error notices, described below), and click Delete.

  4. Click to OpenSelect Claims - You can select claims individually by checking the box beside the claim, or choose Select All or Select None. If the list of claims includes both initial transmissions and resubmissions, select to work with only initial transmissions. You can resubmit additional claims later, as described below.

  5. Click to OpenPrint Pending Claims List - Click Print to obtain a list of the claims you are currently viewing. Claims you have selected for submission are indicated by ( -1) in the left-hand column of the report.

  6. Click to OpenUpload Claims - Click Submit to upload the selected claims to your clearinghouse for processing. (You cannot transmit both first-time and resubmitted claims simultaneously. If your pending claims list includes both initial and resubmitted claims, you must upload one set first, then return to the Electronic Insurance window to upload the remaining claims. See below for details about claim resubmissions.)

  7. Click to OpenWhat Happens Now? - As your insurance claims are being uploaded, you will see messages pop up in your computer's notification area to indicate that the claims were successfully received, and that they have been added to each patient's correspondence history.

Click to OpenVerify Electronic Claim Transmission

It is important to verify that your claims have been submitted successfully. Twenty four hours is usually required for feedback on your claims to be posted.

  1. Submit electronic insurance claims, described above.

  2. Wait 24 hours.

  3. Log into www.dentalxchange.com.

  4. Click Claim Search under the Submission heading.

  5. Select to View All Problem Claims or search for individual submissions and check status.

  6. If needed, correct errors in your data and resubmit, or send additional information as required, described below.

Click to OpenCorrect Errors and Resubmit Electronic Claims

After submitting electronic claims, be sure to clean up any transmission or records errors, and re-submit if needed.

  1. Click to OpenView Errors - Return to the Electronic Insurance window after transmitting electronic forms to review any claims that were not processed successfully. (Unsuccessful transmissions will remain in the pending insurance form list.) Click Error Report to determine the reason the claims were not successful. In addition, you may retrieve rejected claim information when you verify electronic insurance transmission, described above.

  2. Click to OpenCorrect Errors - Go to the appropriate patient folders or other areas of your system to fix any record-keeping or other errors. Common errors include incorrect state abbreviations, mismatched relationship data, and missing employer and group number data.

  3. Click to OpenSelect & Resubmit Electronic Claims - Re-generate the insurance form(s) you need to resubmit, and open the Electronic Insurance window again. Select the claim(s) to transmit (described above), and click Resubmit. The claims will be marked as resubmissions, rather than first-time submissions for the processing clearinghouse.