EServices issue

[drcavola]

Hello to ANYONE who can help with Eservices:

Having massive issues with submitting claims, the ones we've been tracking are Delta Dental, and those claims are NOT going to the insurance company.  Called EServices support this morning multiple times.  Was told to "call the clearinghouse".  Really?  Well, the first number we were given is not in service.  My staff had to call back to EServices, and they gave us another number.  That Clearinghouse is called Change Healthcare.

Is this what Softdent/EServices Support is come to?  "Go ahead and call yourself.  We have no way of tracking if your claims, that we charge some $.65 per claim, for us to process and then get to the clearinghouse, and then to the insurance company".  

How long has this clearinghouse issue been going on?  

[jgoodwin]

I will have one of my escalation agents reach out to you shortly to assist you doctor. 

Thank you,
Jeff

[jenespanet]

We are finding that a lot of our Delta (mostly Wisconisn) claims are needing to be mailed, we set it up as a commercial payor ID 99997. We are located in Virginia. We are also mailing Anthem BCBS claims. We don't understand when companies say they are ECS and the payor IDs don't work through sofdent.

[mdunham]

Our Delta Dental of WI claims have been successfully sending electronically on payer ID 39069.    Perhaps check the way your provider has the Prov/PRac ID  set up in ECS?   Also, are the plan and company set up to send ECS?    I'm throwing stuff out there because I am able to successfully send to all Deltas and Anthems.   By Anthem, do you mean your Anthem local of WI?

[jenespanet]

we were using that payor id number and Delta told us they were not receiving claims. We use Change Healthcare as our clearinghouse through Softdent, is that who you use? We are not in Wisconsin, we are in Virginia. None of Anthem plans, local or through any other state. Who is your clearinghouse? 

[jenespanet]

I meant to say NONE of our Anthem BCBS go through electronically. We don't actually mail the claims from our office, but Change Healthcare does. We submit them electronically but they are mailed. When we used Remote Lite it was not that way.

[mdunham]

I see, we use Carestream E-services.   

[drcavola]

@jgoodwin - thanks for arranging the call.  It's been at least 4 weeks, maybe more, since we got bulk payments from Delta Dental.  We've been getting concerned.  Last week I resubmitted all 4 pages of outstanding claims.  Today we checked with DD online, still no receipt of payments.  That's when we called for Support ... I wish Softdent had the ability to record those changes to the DD insurance company thru the audit trail.  But no.  I wish I could tally all the times we've submitted the same claims, in error ... at least two, maybe more.  Not counting the manual slog of having to cancel each claim, then resubmit.  So that's another echarge ... wondering if someone at Eservices would have some compassion and throw us a credit of some sort on our account.  

[jgoodwin]

What is the best way to reach you doctor?

[drcavola]

call our office number, 770-929-8555, and ask for Wanda ... she's been working a lot of this DD issue. Thx

[jenespanet]

Can you share if there was a resolution? We are going through accounts and finding a lot of insurance companies have not received our claims, even if they were supposed to be mailed....ugh.

[jgoodwin]

Can you please share your account number so I can pull your account and have a rep reach out?

[drcavola]

If it's us, then I believe the account number is 24.4789.  Thx

[jenespanet]

Are you replying to me? Our number is 571-248-4415, thanks.

[jgoodwin]

@jenespanet yes. Thank you. I will have an agent reach out shortly.

[jenespanet]

We have spoken to Kyle a few times and his help has been invaluable. we upgraded to the cloud in October and I still feel like we are learning new things. Kyle gave us some great info, helped us iron out some missing payor ids and, overall, was the best! 

Maybe Softdent needs to change the way they train offices for the eservices program, we have learned more in two phone conversations than the last 6 months.

All this to say, I think we are on our way to getting paid....and that's awesome!

[jgoodwin]

I love hearing feedback from clients like this! Thank you for taking the time to express your gratitude. We are very proud of our team!

[drcavola]

I will second, somewhat conditionally, about the help while we were in need.  Our normal Delta Dental electronic payment hit the bank this morning, with over 4 pages of claims that were sent out into some ozone layer and disappeared.  Yes, we know that the payor number was the issue.  

Here's the conditional:  a) why is there not some sort of audit trail when a payor number gets changed?  b) why is there not some sort of electronic services sympathy by way of a credit for the multiple times each of those Delta Dental claims went out into the ozone?  I don't believe anyone from support ever looked into that depth for the issue, and finally, c)  Why is it that we have to get our feathers ruffled and make this exchange into a "hey, where's the support?".  Can it be that support has been outsourced and now there are few who have the depth of knowledge that is needed to work through the issues we're having almost on a weekly basis?

[paul_snyder]

Good Day Dr. Cavola, 

Our sincere apologies for any challenges you have experienced with our support team.  If you have specific examples of these challenges (i.e. date/time of call), I am happy to investigate the issues and take corrective action.  As you are aware, Carestream Dental has established a global support center, which is an extension of the team. Please understand that the agents are still learning and are continually being upskilled.  As always, we value your business and appreciate your patience.  I can assure you that this knowledge gap is only a temporary situation.

Kind Regards,

Paul Snyder 

[drcavola]

Hello Paul,

And thanks for the response.  Upon a quick check, I found 5 examples, I'll list the patient id below, of which we did the following:

a) submitted the original claim, on the original DOS,

b) resubmitted the original claim some few weeks later.

c) After finding out the payor id issue, we had to "cancel, resubmit new claim, and delete the old claim" process (old way of doing so, btw), and this was last week. All 4 pages worth of individual claims, I might add.

So by my count, there are three total submissions for each of the 4 pages or so of Delta patients.

Here are those 5 examples, by patient id #:

23001, 830302, 505801, 812901, 122305.

Thanks,

Dr. Ron Cavola

[jgoodwin]

I will have one of my escalation reps reach out and work with Wanda to get you back on track and all fixed up.